Association Between IL 36 And Degree Of Myocardial Injury In Acute Coronary Syndrome

BackgroundAcute coronary syndrome(ACS)is a set of clinical syndrome caused by acute myocardial ischemia,it mainly includes unstable angina(UA),non-ST segment elevation myocardial infarction(NSTEMI)and ST segment elevation myocardial infarction(STEMI).In recent years,with the improvement of living environment,the incidence of acute coronary syndrome has maintained at a high level.Atherosclerotic unstable plaque rupture or erosion of the mentor coronary thrombosis,accompanied by varying degrees of surface thrombosis,vasospasm and distal vascular embolism,is recognized as the main pathological basis of most acute coronary syndrome.A large number of activated macrophages in unstable plaque can produce a series of protease,which belong to extracellular matrix components,and the unstable plaque has a lot of activated T lymphocytes,the lymphocytes can synthesize a large number of inflammatory factors,such as IL-1?IL-6?IL-17?TNF-??hs-CRP?YKL-40?HMGB1?MMP-9?MIF and so on.The pathophysiology of myocardial infarction patients has special characteristics,the change of inflammatory factor,regulation and the chemotactic factor have become more and more important for clinical doctors.IL-36,a new member of the IL-1 family,is an inflammatory marker associated with acute and chronic inflammation and is involved in the synthesis of extracellular matrix collagen and the activation of macrophages.IL-1 involved in impairing endothelial function,artery atheromatous plaque formation and the rupture of unstable plaque,which means a lot in occur,development and prognosis,while IL-36 in atherosclerosis and acute coronary syndrome plays a role,but there are few correlation studies in IL-36 and the myocardial injury in patients with acute coronary syndromes.ObjectiveIn this research,we explore the relationship of IL-36 and the myocardial injury in the patients with ACS though the detection the concentration of IL-36?IL-6 and TnI.We want to explore the relationship between IL-36 and myocardial damage in patients with ACS.Methods1.Study populations and groupsThere are 102 patients with ACS in this study includes 60 patients(female 45,male 15)with acute myocardial infarction and 42 patients(female 22,male 20)with unstable angina.All cases were recruited from ward patients of the Shandong University Second Hospital between March 2018 and July 2018.According to the fourth edition of the global unified definition of myocardial infarction in 2018,the patients in group A we choose met the diagnostic criteria for type I myocardial infarction,and the patients in group B met the diagnostic criteria of unstable angina.At the same time,46 healthy adults(female 34,male 17)were examined in the health examination center of the hospital as the control group C,All indexes were normal.And the exclusion criteria is:Severe infection,dehydration,severe trauma and mental stress;Uncontrolled secondary hypertension;Acute cardiovascular accident;Congenital heart disease,Cardiomyopathy,Heart valve disease;Arrhythmia diseases;Combined with other serious chronic diseases;Chronic granulomatous inflammation;Skin diseases;Inflammatory bowel disease;Diseases of thyroid;Autoimmune diseases;Tumor.All participants signed the informed consent form,inquired about their past medical history,drinking history and smoking history,and had a comprehensive physical examination.Height,weight,blood pressure and heart rate were measured.Body mass index(BMI)was calculated.BMI= weight/height 2(kg/m2).2.The determination of various biochemical indexesWe draw the morning fasting venous blood in the subjests.And we detect GLU,TC,TG?LDL-C,HDL-C,CRP,hs-cTnl,MYO,IL-6 in medical clinical laborator.3.The determination of serum IL-36Subjects were fasting venous blood samples,centrifugal serum after inserted in sterile EP,minus 80 ° in the refrigerator frozen.Serum IL-36 concentration was determined by ELISA in the laboratory.4.Statistical analysisAll data were analyzed by IBM SPSS Statistics 21.0 software.We use(x±s)to express measurement data,N(%)was used for counting data.comparison between independent group by t test,multiple sets of comparison between using single factor analysis of variance,after the two comparative analysis using the LSD method.Pearson correlation analysis was used to analyze the correlation between the two variables,and chi-square analysis was used for comparison between groups.The influencing factors were analyzed by binary Logistic regression.P<0.05 was statistically significant.Results1.There was no significant difference between the three groups in age,gender,BMI,drinking,TC,LDL-C(P>0.05).There were statistically significant between the three groups in smoking,BBP,DBP,PP,GLU,HDL-C,CRP,IL-6,MYO,hs-cTnI(P<0.05).2.Comparison results showed that the BBP,PP,GLU in the patients with ACS were higher than that of C group,and the difference had statistically significant(P<0.01).HDL-C,CRP,IL-6,MYO and hs-cTnl were increased in patients with ACS,the difference between groups had statistically significant(P<0.01).3.There was significant positive correlation between IL36,IL6 and Tnl in group A and group B(P<0.05).The higher IL36 level was,the higher IL6 and hs-cTnI levels were.4.Logistic regression analysis showed that IL36 was an independent risk factor for ACS(P= 0.002<0.05).Therefore,the higher IL36 level was,the higher the risk of heart disease was.Conclusion1.Increased blood pressure and blood sugar,decreased HDL-C,and increased CRP and IL-6 are the influencing factors of ACS2.The concentration of IL-36 is significantly increased in patients with ACS,and IL-36 may be closely related to the occurrence and development of ACS vulnerable plaques.3.IL-36 is related to the degree of myocardial injury in patients with ACS,which may have certain predictive value for assessing the degree of myocardial injury in patients with ACS.4.Il-36 is a high risk factor of ACS and an independent influencing factor,so IL-36 may be of great significance in the prediction of ACS.