急性心肌梗死患者冠脉病变与mCRP、pCRP及IL-39的相关性

Correlation between coronary artery disease and mCRP,pCRP and IL-39 in patients with acute myocardial infarction

目的 探讨急性心肌梗死(AMI)患者外周血中单聚体C反应蛋白(mCRP)、五聚体C反应蛋白(pCRP)、白细胞介素-39(IL-39)与冠脉病变程度的相关性。方法 选取2020年9月—2021年1月于安徽医科大学第一附属医院东城院区心血管内科就诊的经冠脉造影确诊AMI的50例患者作为观察组,其中31例ST段抬高型心肌梗死(STEMI)、19例非ST段抬高型心肌梗死(NSTEMI),并经Gensini评分系统将评分≤40分的12例作为轻度病变组,40分<评分≤80分的22例作为中度病变组,评分>80分的16例作为重度病变组,另选取同期20例就诊本院经冠脉造影检查未见血管异常或狭窄的患者作为对照组。采集入院12 h内静脉血,采用双抗体夹心法测定mCRP、pCRP、IL-39,并检测HDL-C、TG、BNP、LDL-C、TC、LVEF、cTnI、CK-MB、Mb等指标,对两组间及观察组内进行比较,分析冠脉病变程度与mCRP、pCRP、IL-39等相关指标的相关性。结果 观察组的性别、BMI、平均年龄、高血压病史、pCRP、糖尿病史和对照组比较差异无统计学意义(P>0.05),观察组TG、TC、LDL-C、BNP、mCRP、IL-39、cTnI、CK-MB、Mb显著高于对照组,HDL-C、LVEF明显低于对照组(P<0.05);观察组组内冠脉病变程度轻中重3组间比较,性别、高血压病史、糖尿病史、LDL-C、年龄、HDL-C、 pCRP、cTnI、CK-MB、Mb差异均无统计学意义(P>0.05),mCRP、LVEF、IL-39、BNP差异明显(P<0.05);冠脉病变程度Gensini评分与mCRP(r=0.656,P<0.05)、IL-39(r=0.517,P<0.05)、BNP(r=0.609,P<0.05)呈正相关,和LVEF呈负相关(r=-0.615,P<0.05)。结论 AMI患者的冠脉病变程度与外周血中mCRP、IL-39存在相关性,mCRP、IL-39水平越高,病变程度越严重,与pCRP无显著相关性,提示检测mCRP、IL-39对AMI患者的冠状动脉病变程度具有重要参考价值。

Objective To investigate the correlation between monomeric C-reactive protein(mCRP),pentameric C-reactive protein(pCRP)and IL-39 in peripheral blood and the degree of coronary artery lesions in patients with acute myocardial infarction(AMI).Methods From September 2020 to January 2021,50 patients with AMI diagnosed by coronary angiography were selected as the experimental group,including 31 patients with ST-segment elevation myocardial infarction(STEMI)and 19 patients with non-ST-segment elevation myocardial infarction(NSTEMI),and 12 patients with scores≤40 were classified as mild lesions by the Gensini scoring system.The Gensini scoring system was used to classify 12 cases with a score of less than 40 as mild lesions,22 cases with a score of 40 points<score≤80 were set as moderate lesions group and 16 cases with a score of>80 as severe lesions,and 20 patients who did not have any abnormalities or stenosis on coronary angiography at the same time as the control group.Venous blood was collected within 12h of admission,and mCRP,pCRP and IL-39 were measured by double antibody sandwich method,and HDL-C,TG,BNP,LDL-C,TC,LVEF,cTnI,CK-MB and Mb were measured.The two groups and the experimental group were compared,and the correlation between the degree of coronary artery lesions and mCRP,pCRP,IL-39 and other related indexes was analysed.Results There was no significant difference between the experimental group and the control group in terms of gender,BMI,mean age,history of hypertension,pCRP and history of diabetes mellitus(P>0.05);TG,TC,LDL-C,BNP,mCRP,IL-39,cTnI,CK-MB and Mb were significantly higher in the experimental group than in the control group;HDL and LVEF were lower than in the control group,with significant differences(P<0.05);there were no significant differences in gender,history of hypertension,history of diabetes,LDL-C,age,HDL-C,pCRP,cTnI,CK-MB,Mb(P>0.05)and mCRP,LVEF,IL-39,BNP(P<0.05)when comparing between the three groups of mild to severe coronary lesions within the experimental group.The Gensini score for the degree of coronary lesion was positively correlated with mCRP(r=0.656,P<0.05),BNP(r=0.517,P<0.05),IL-39(r=0.609,P<0.05)and negatively correlated with LVEF(r=0.615,P<0.05).Conclusion The degree of coronary artery lesions in AMI patients correlated with mCRP and IL-39 in peripheral blood.The higher the level of mCRP and IL-39,the more severe the lesions,while there was no significant correlation with pCRP,suggesting that the detection of mCRP and IL-39 has important reference value for the degree of coronary artery lesions in AMI patients.