Correlation Analysis Of Acute Coronary Syndrome With Chlamydia Pneumoniae Infection And Interleukin-6 TNF-α

Objective: In this study,the serum levels of IL-6,TNF-α and CPn-IgG in patients with acute coronary syndrome were detected by chemiluminescence and ELISA(enzyme-linked immunosorbent assay).The relationship among Chlamydia pneumoniae infection and IL-6,TNF-α and ACS were investigated and the correlation between the expression level and the degree of coronary artery disease was further investigated.Methods:(1)Subjects: 124 cases were selected from August 2017 to January 2018,84 patients with acute coronary syndrome(ACS)were diagnosed as acute coronary syndrome(ACS),who were admitted to Department of Cardiology,the Second Affiliated Hospital of Dalian Medical University because of chest pain.Among them,68 were male,56 were female,and the age range was 35-86 years old.All the patients underwent coronary angiography and were diagnosed as 84 cases of acute coronary syndrome(ACS),of which 41 cases of unstable angina pectoris group(unstable angina pectoris,UA),and 43 cases of acute myocardial infarction(acute myocardial infarction,AMI).Angiography showed negative or coronary artery stenosis < 50% in 40 cases in the control group.(2)Exclusion criteria: cardiopathy,Heart valve disease,cardiac infarction and secondary myocardial infarction within 6 months,cardiac function level Ⅲ and Ⅳ,liver and kidney dysfunction,infection,rheumatic immune disease,coagulation dysfunction or malignant tumor were all excluded,and no regularities of lipid medication were taken in the first 3 months of admission.(3)Biochemical examination: all subjects were taken cubital vein blood from the morning after admission,and blood routine,liver biochemistry,renal function,blood coagulation routinewere measured in our laboratory.CTNI,proBNP,CK-MMB,TC,LDL-C,HDL-C were found in the serum of patients.(4)The serum CPn-IgG、IgM antibody and its titer of each patient were determined by Elisa(the ratio<0.8 was negative,the ratio≥0.8<1.1 was suspicious,the ratio ≥1.1was positive).(5)The levels of IL-6 and TNF-α were measured by chemiluminescence method,thenormalvalues were: IL-6<3.4 pg/ml,TNF-α <8.1 pg/ml,and the normal value of fibrinogen was 2<Fbg<4 by using scattering immunoturbidimetry.Results:1.Compared with the positive rate of CPn-IgG antibody(47.5%)in the control group,the positive rate of CPn-IgG antibody(96.4%)in the ACS group were significantly higher,the difference was statistically significant(P<0.01).Compared with the level of titer(1.26+0.68)in the control group,and the titer level(2.08+0.59)in the ACS group were significantly higher,the difference was statistically significant(P<0.01).The ACS group was divided into AMI group and UA group.Compared with the control group CPn-IgG titer level(1.26+0.68),UA group CPn-IgG titer level(1.93+0.54)significantly increased.Compared with group UA CPn-IgG titer level(1.93+0.54),the level of CPn-IgG titer(2.22+0.61)in group AMI was significantly higher.The differences among groups were statistically significant(P<0.05).Compared with the positive rate of CPn-IgM antibody(0%)in the control group,the positive rate of CPn-IgM antibody in group ACS(0%)was not statistically significant(P>0.05).2.Compared with control group TC(4.08+0.85)and LDL-C(2.71+0.69),ACS group TC(4.75+1.12)and LDL-C(3.09+1.11)increased significantly.Compared with the control group HDL-C(1.23+0.21),ACS group HDL-C(1.09+0.29)decreased significantly,the difference was statistically significant(P<0.05).The ACS group was divided into AMI group and UA group.Compared with control group IL-6(4.99+2.84)and TNF-α(21.12+18.85),UA group IL-6(10.91+8.83)and TNF-α(45.55+39.35)increased significantly.Compared with group UA IL-6(10.91 + 8.83)and TNF-α(45.55+39.35),AMI group IL-6(27.41+13.76)and TNF-α(62.49+37.38)increased significantly.The differences between groups were statistically significant(P<0.05).Then the ACS group was divided into IgG positive group and IgG negative group.Compared with IgG negative group IL-6(3.44+1.82),TNF-α(7.40+1.13),TC(2.80+0.24),LDL-C(1.41+0.17),in IgG positive group IL-6(19.94+14.14),TNF-α(54.93+38.86),TC(4.81+1.09),LDL-C(2.75±1.15)increased significantly.The difference was statistically significant(P<0.05).3.CPn-IgG,IL-6,TNF-α,TC,LDL-C,HDL-C,hypertension,diabetes,sex,smoking and body mass index were included in the multiple factor analysis of two yuan logistic regression model.The results showed that CPn-IgG and IL-6 were independent risk factors for acute coronary syndrome(P<0.05),(OR values were 5.62 and 1.21respectively).TNF-α is a risk factor for acute coronary syndrome,but it is not an independent risk factor.4.The results of Pearson correlation analysis showed that the level of serum CPn-IgG titer(2.08+0.59),IL-6(19.35+14.22)in ACS group and Gensini score of coronary artery disease(59.49+23.22)were positively correlated(R values was 0.685 and 0.353respectively),and the difference was statistically significant(P<0.01).Conclusion:1.Serum CPn-IgG titer is positively correlated with the incidence of acute coronary syndrome.2.The levels of IL-6,TNF-α,Fbg,WBC,TC and LDL-C in serum CPn-IgG positive group were higher than those in CPn-IgG negative group.It suggests that CPn infection may regulate inflammatory factors and blood lipid levels by damaging vascular endothelial cells,leading to the development of acute coronary syndrome.3.Serum CPn-IgG and IL-6 are independent risk factors for acute coronary syndrome and positively correlated with the severity of coronary artery disease(Gensini score).TNF-α is a risk factor for acute coronary syndrome,but is not an independent risk factor.