Changes In Levels And Related Factors Analysis Of Plasma Inflammatory Cytokines In Diabetic Patients With Coronary Artery Disease Undergoing CABG Surgery

Objective:Our goal is to conduct research on patients with diabetes mellitus complicated with coronary artery disease and analyze the levels of inflammatory cytokines in their plasma,so as to provide effective guidance and reference for CABG surgery.Methods:In the process of this study,patients from April 2019 to April 2020 were selected,all of whom were from the Affiliated Hospital of Chengde Medical College,with a total of 77 patients.There were 19 patients with coronary artery disease complicated with diabetes,and 28 patients with coronary artery disease without diabetes,and 30 normal cases without coronary artery problem(normal group,NG).We detected plasma cytokine levels by ELISA method.Combining with WBC,TBil,AST,TG,TCH,HDL-C,LDL-C,LDH,CK,BUN,UA,FT3,FT4,TSH,LVEDD,BMI,medical history,evaluated the expected perioperative period value of the three cytokines to patients undergoing coronary artery bypass grafting after logistic regression analysis.Results:1.Comparison of general clinical characteristics in three groupsThe chest pain history,hypertension history,the stroke history and random blood glucose levels were analyzed to study.Based on this analysis,both the CAD-DM group and the CAD group were higher than the NG group.The blood glucose levels within the CAD-DM group were analyzed to be higher than the CAD group,and the difference was statistically significant(P<0.05).LDL-C levels within the CAD-DM group were analyzed,and the data were higher than those in the CAD group,but the difference was not statistically significant(P>0.05).(Table 1)2.Comparison of inflammatory cytokines level in three groupsCompared with NG group,the levels of MCP-1 and TNF-α in CAD-DM group and CAD group were significantly increased,while the levels of TGF-β were significantly decreased.Compared with CAD group,the levels of MCP-1 and TNF-α in CAD-DM group were significantly increased,while the levels of TGF-β were significantly decreased,with statistical significance(P < 0.05).(table 2).3.Correlation analysisThe results of Pearson correlation analysis demonstrated that the levels of MCP-1 and TNF-α in the three groups were positively correlated,while the levels of MCP-1 and TNF-α in the three groups were negatively correlated with the levels of TGF-β.(all P<0.05).(Table 3)Spearman correlation analysis demonstrated that the level of MCP-1was positively correlated with the chest pain history and the level of random blood glucose,while the levels of LDH and FT3 were negatively correlated with it,respectively(P<0.05).The level of TNF-α was positively correlated with the age,chest pain history and the level of random blood glucose,while the level of FT3 was negatively correlated with it,respectively(P<0.05).The level of TGF-β was positively correlated with the levels of HGB,HCT and FT3,while the chest pain history and the level of random blood glucose were both negatively correlated with it,respectively(P<0.05).(Table 4 and Fig.2)4.Binary logistic regression analysis on relative factors for coronary artery disease combined with diabetes.Binary logistic regression analysis was used to study the levels of MCP-1 and TG,the history of stroke were associated with the development of CAD-DM,while TGF-β was a protective factor(P<0.05).Conclusion:1.The levels of MCP-1 and TG,the history of stroke were influencing factors of the development of CAD-DM.TGF-β was a protective factor,combined detection of two inflammatory cytokines have the guiding significance for CABG operation.2.Both coronary artery disease and diabetes could lead to the increase of the levels of inflammatory cytokines.And patients simultaneously with diabetes and coronary artery disease had the higher levels of them.