| Objective:1.To observe the level of serum proprotein convertase subtilisin/kexin type9(PCSK9)in patients with acute myocardial infarction(AMI)complicated with type 2 diabetes mellitus(T2DM).2.To investigate the correlation between serum PCSK9 level,blood glucose control level and inflammatory reaction in patients with AMI and T2 DM.Methods:The patients over the same period were divided into three groups: the patients with AMI and T2DM(n=100),the non-diabetic patients with acute myocardial infarction(n=61)and the patients with chronic stable coronary heart disease(n=70).Diagnostic criteria of acute myocardial infarction consistent with the 2011 ESC guidelines for diagnostic and therapeutic guidelines for acute myocardial infarction,and diagnostic criteria of diabetes meets the 2013 ada diagnostic criteria for diabetes.The basic clinical data of each patient were collected.Coronary angiography was performed in selected patients in strict accordance with the guidelines of percutaneous coronary intervention(2012),which was developed by the Chinese Academy of Medical Sciences.And quantitative evaluation of coronary artery stenosis was performed by Gensini integral system.Venous blood was taken of each patient second days after admission,and then detected the level of Hs-CRP?LDL-C? HDL-C? TG and TC by the Beckman AU5800 automatic biochemical analyzer,the level of HbA1 c by D-10 automatic glycosylated hemoglobin analyzer(BIO-RAD),and the serum PCSK9 level by ELISA.And correlation analysis was conducted on serum PCSK9 level and HbA1 c that reflects blood sugar control levels and inflammatory markers Hs-CRP.Result:1.There were no significant differences in age,sex,smoking history,hypertension history,triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein of each group(P>0.05).And there was significant difference in fasting blood glucose level between three groups(P<0.05).2.The level of serum PCSK9 and concentration of HbA1 c and hs-CRP in the AMI and T2 DM group and the AMI group were both higher than that of the chronic stable coronary heart diseasel group(p < 0.05).3.The level of serum PCSK9,HbA1 c and hs-CRP of the AMI and T2 DM group was higher than that of the AMI group;4.In AMI and T2 DM group,the serum PCSK9 level was positively correlated with Gensini score(r=0.287,P<0.05)and Hs-CRP(r=0.526,P <0.05),but had no correlation with HbA1c(r=0.067,P>0.05)and fasting blood glucose(r=0.118,P>0.05).Conclusion:1.The level of serum PCSK9 in patients with acute myocardial infarction complicated with type 2 diabetes mellitus was higher than that in the other groups,suggesting that PCSK9 may be involved in the process of the instability of coronary plaque and the disorder of glucose metabolism,suggesting that PCSK9 could be used as an indicator of the severity of the disease.2.The level of serum PCSK9 was positively correlated with Gensini score and Hs-CRP in patients with AMI complicated with T2 DM,suggesting that the detection of PCSK9 may help to determine the severity of coronary artery disease. |
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