Visfatin、IL-33及EMP与糖尿病合并急性冠状动脉综合征患者疾病进展和预后的相关性

Correlation of Visfatin,IL-33 and EMP with Progression and Prognosis of Disease in Patients with Diabetes Mellitus Complicated with Acute Coronary Syndrome

目的分析内脏脂肪素(visfatin)、白介素-33(IL-33)及内皮微粒(EMP)与糖尿病合并急性冠状动脉综合征(ACS)患者疾病进展及预后的相关性。方法收集2013年4月—2016年6月收治的糖尿病合并ACS患者96例(糖尿病合并ACS组)的临床资料,并选取同期的单纯糖尿病患者(单纯糖尿病组)以及健康体检人群(健康组)各96例。对比不同人群visfatin、IL-33及EMP表达差异,分析visfatin、IL-33及EMP与糖尿病合并ACS患者疾病进展及预后的相关性。结果健康组visfatin表达水平最高,其次为单纯糖尿病组,最低为糖尿病合并ACS组(P<0.05)。糖尿病合并ACS组IL-33、EMP表达水平最高,其次为单纯糖尿病组,最低为健康组(P<0.05)。随着糖尿病合并ACS患者的病情进展,IL-33、EMP表达水平逐渐升高,visfatin表达水平逐渐降低(P<0.05)。预后良好患者75例,预后不良患者21例,预后良好患者visfatin表达明显高于预后不良患者,IL-33及EMP表达水平明显低于预后不良患者(P<0.05)。visfatin<2μg/L、IL-33≥90 ng/L、EMP≥946 pg/ml均为影响糖尿病合并ACS患者预后的独立危险因素(P<0.05,P<0.01)。结论糖尿病合并ACS患者visfatin表达降低,IL-33、EMP表达则升高,三者表达水平与糖尿病合并ACS患者冠状动脉病变程度有关,可为患者预后评估提供参考。

Objective To analyze the correlation of visfatin,interleukin-33(IL-33)and endothelial microparticles(EMP)with progression and prognosis of disease in patients with diabetes mellitus complicated with acute coronary syndrome(ACS).Methods The clinical data of 96 patients with diabetes mellitus complicated with ACS(diabetes combined with ACS group)admitted from April 2013 to June 2016 were collected.In the meantime,96 patients with simple diabetes(simple diabetes group)and healthy people(healthy group)were selected.The expression differences of visfatin,IL-33 and EMP in different populations were compared,and the correlation of visfatin,IL-33 and EMP with progression and prognosis of disease in patients with diabetes mellitus complicated with ACS was analyzed.Results The healthy group had the highest expression level of visfatin,followed by the simple diabetes group and the diabetes combined with ACS group(P<0.05).The expression levels of IL-33 and EMP in the diabetes combined with ACS group were the highest,followed by the simple diabetes group and the healthy group(P<0.05).With the progress of diabetes mellitus patients with ACS,the expression levels of IL-33 and EMP were gradually increased,and the expression levels of visfatin were gradually decreased(P<0.05).There were 75 cases with good prognosis and 21 cases with poor prognosis.The expression of visfatin in those with good prognosis was significantly higher than that in those with poor prognosis,whereas the expression levels of IL-33 and EMP were significantly lower than those with poor prognosis(P<0.05).Visfatin<2μg/L、IL-33≥90 ng/L、EMP≥946 pg/ml were all independent risk factors affecting the prognosis of patients with diabetes mellitus complicated with ACS(P<0.05,P<0.01).Conclusion The expression of visfatin in the patients with diabetes mellitus complicated with ACS was decreased,while the expression of IL-33 and EMP was increased.The expression levels of the three were related to the degree of coronary artery disease in patients with diabetes and ACS,which can provide a reference for the prognosis evaluation of patients.