急性心肌梗死患者血清IL-10、Ang-Ⅱ与冠脉病变严重程度的关系

Relationship Between Serum IL-10,Ang-Ⅱand Severity of Coronary Artery Disease in Patients with Acute Myocardial Infarction

目的分析血清白细胞介素(IL)-10、血管紧张素(Ang)-Ⅱ与急性心肌梗死(AMI)患者冠状动脉狭窄程度的关系。方法本研究为前瞻性研究,以2020年4月至2022年3月急诊入院拟行血管内介入诊治的120例AMI患者作为研究对象,根据Gensini冠状动脉评分评估患者冠状动脉狭窄程度,分为轻度、中度、重度。在介入治疗前即对患者进行相关检查,检查项目包括血清IL-10、Ang-Ⅱ、肌钙蛋白I(cTnI),心肌酶[血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)],血浆D-二聚体(D-D)等,分析血清IL-10、Ang-Ⅱ与AMI患者冠状动脉狭窄程度的关系及对冠状动脉狭窄程度的影响。结果研究中120例AMI患者,经剔除后以116例为研究对象,116例患者Gensini评分为22~76分,轻度狭窄28例,中度狭窄55例,重度狭窄33例。不同狭窄程度患者Killip分级,血清IL-10、Ang-Ⅱ、cTnI、CK、CK-MB、LDH,血浆D-D比较,差异有统计学意义(P<0.05);但不同狭窄程度患者Killip分级和血浆D-D两两比较,差异无统计学意义(P>0.05)。使用Kendall’s tau-b相关系数检验,血清IL-10、Ang-Ⅱ、cTnI、CK、CK-MB、LDH均与AMI患者冠状动脉狭窄程度呈正相关(r>0,P<0.05)。构建多元logistic回归模型提示,血清IL-10、Ang-Ⅱ高表达均能够加重AMI患者冠状动脉狭窄程度(P<0.05)。结论血清IL-10、Ang-Ⅱ均与AMI患者冠状动脉狭窄程度呈正相关,且能够促进冠状动脉狭窄进展,加重狭窄程度。

Objective To analyze the relationship between serum interleukin(IL)-10,angiotensin(Ang)-Ⅱand the degree of coronary artery stenosis in patients with acute myocardial infarction(AMI).Methods This study was a prospective study,with 120 AMI patients who were hospitalized in emergency department from April 2020 to March 2022 and planned to undergo intravascular intervention as the research object.The degree of coronary artery stenosis was assessed according to Gensini coronary artery score,which was divided into mild,moderate and severe.The patients were examined before interventional therapy,including serum IL-10,Ang-Ⅱ,cardiac troponin I(cTnI),myocardial enzymes[serum creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)],plasma D-Dimer(D-D).The relationship between serum IL-10,Ang-Ⅱand the degree of coronary artery stenosis in patients with AMI and its influence on the degree of coronary artery stenosis were analyzed.Results Among the 120 patients with AMI in the study,116 were selected as the actual subjects after exclusion.The Gensini score of 116 patients was 22-76,including 28 cases of mild stenosis,55 cases of moderate stenosis and 33 cases of severe stenosis.There were differences in Killip grade,serum IL-10,Ang-Ⅱ,cTnI,CK,CK-MB,LDH and plasma D-D in patients with different degrees of stenosis(P<0.05).However,there were no differences in Killip grade and plasma D-D between patients with different degrees of stenosis(P>0.05).Using Kendall’s tau-b correlation coefficient test,serum IL-10,Ang-Ⅱ,cTnI,CK,CK-MB,LDH were positively correlated with the degree of coronary artery stenosis in patients with AMI(r>0,P<0.05).The construction of multiple logistic regression model suggested that the high expression of serum IL-10 and Ang-Ⅱcould aggravate the degree of coronary artery stenosis in patients with AMI(P<0.05).Conclusion Serum IL-10 and Ang-Ⅱare positively correlated with the degree of coronary artery stenosis in patients with AMI,and can promote the progression of coronary artery stenosis and aggravate the degree of coronary artery stenosis.