| Objective: Acute myocardial infarction(Acute Myocardial Infarction,AMI)is a clinically common acute critical illness with high mortality and high hospitalization rate that is seriously harmful to human health.Ventricle Remodel(VRM)after AMI is a key factor leading to disease progression such as malignant arrhythmia,heart failure(HF),and sudden cardiac death.Current studies have shown that neuroendocrine,hemodynamic load changes,and inflammatory responses play an important role in the development of acute myocardial infarction,but the specific mechanism of VRM after AMI remains unclear.In this study,by observing the dynamic evolution of serum interleukin-11(Interleukin 11,IL-11)in patients with AMI after emergency percutaneous coronary intervention(PCI),combined with 3 days,1 week,and Ventricular remodeling related indexes at 2 weeks,1 month,3 months and 6months(end of follow-up).To explore the correlation between serum IL-11 level and ventricular remodeling after the first AMI,and provide an important basis for the clinical evaluation,treatment and prognosis of clinical AMI.Methods: Included in the inpatient treatment of cardiovascular medicine in the Fourth Affiliated Hospital of Guangxi Medical University,from January2018 to January 2019,the first confirmed acute ST segment elevation myocardial infarction(ST-segment elevation myocardial infarction,STEMI)),and 46 patients were successfully treated by emergency PCI,including 19 cases of anterior wall,8 cases of extensive anterior wall,16 cases of inferior wall,3cases of posterior wall;within 12 hours after admission,1 week,2 weeks,At seven time points: 3 weeks,1 month,3 months,and 6 months,venous blood was drawn to determine serum IL-11 and other biochemical indicators.3 days,1week,2 weeks,1 month,3 after admission The left ventricular end diastolic volume(LVEDV),the left ventricular end diastolic diameter(LVEDD),the left ventricular ejection fraction(Left Ventricular Ejection Fraction,LVEF)and other indicators,both groups of patients were given standard coronary heart disease medication.In addition,30 patients with stable coronary heart disease(SCHD)who were diagnosed for the first time in the same period of hospitalization were selected,and 30 healthy patients in outpatient clinic were selected as controls.Analyze the changes of serum IL-11 and its correlation with ventricular remodeling indexes after successful PCI in patients with AMI.Let LVEDV0 be the left ventricular end-diastolic volume 3 days after admission to AMI patients,LVEDV1 be the left ventricular end-diastolic volume at the end of follow-up(6 months)in AMI patients,△ LVEDV% is the growth rate of LVEDV,△ LVEDV% =(LVEDV1-LVEDV0)/LVEDV0×100%.Among patients in the AMI group,△LVEDV ≥ 20% was divided into the ventricular remodeling group,and △ LVEDV <20% was the non-remodeling group,and the differences between the two groups were compared.SPSS 26.0 statistical software was used for data analysis,mean ± standard deviation(±S)was used for measurement data,t test or analysis of variance was used for comparison of mean difference between groups,and count data was chi-square test.Pearson linear correlation analysis was used to compare the correlation between variables.P<0.05 was considered statistically significant.Results:(1)The average level of serum IL-11 in patients with acute myocardial infarction was(135.09±49.24)ng/L,the level of serum IL-11 in the stable coronary heart disease group was(22.47±4.22)ng/L,and the serum IL in healthy subjects group The level of-11 was(4.53±2.10)ng/L.The serum IL-11 concentration of the three groups was compared between two groups.The serum IL-11 of patients in the AMI group was significantly higher than that of the healthy examinee group and stable coronary heart disease group.Serum IL-11 in patients with stable coronary heart disease was higher than that in healthy people,the difference was statistically significant(P<0.05);LVEDV(109.43±17.91)ml,LVEDD(47.74±3.94)3 days after the onset of AMI group mm,LVEF(52.74±6.62)%,LVEDV(71.77±5.47)ml,LVEDD(41.23±2.16)mm,LVEF(69.23±3.14)%,LVEDV(83.27±10.66)in the stable coronary heart disease group ml,LVEDD(44.27±1.26)mm,LVEF(60.90±3.58)%,comparing the ventricular remodeling indexes of the three groups of people,the LVEDV and LVEDD of the AMI group were significantly higher than those of the healthy group and stability Coronary heart disease group,LVEF was significantly lower than healthy physical examination group and stable coronary heart disease group,patients with stable coronary heart disease group LVEDV,LVEDD were higher than healthy physical examination group,its LVEF was lower than healthy physical examination group,the differences were statistically significant Significance(P<0.05).(2)Serum IL-11 in patients with acute myocardial infarction reached a peak within 12 hours of admission and maintained until 2 weeks of AMI.At 12 hours,1 week and 2 weeks,the level of IL-11 was(128.71±24.05)ng/L,(125.30±25.20)ng/L,(126.22±22.06)ng/L,there was no statistical difference between the two pairs(all P>0.05);serum IL-11 level was 3 weeks(92.28±20.84ng/L)Declining trend,1 month(53.83±14.98 ng/L),3 months(52.46±13.83ng/L),6 months(52.24±14.56 ng/L),comparison between groups after 1 month There was no statistical difference(all P>0.05),that is,AMI showed a plateau in January,and maintained a low level of expression.Serum IL-11 levels in patients with acute myocardial infarction in all time periods were higher than those in the healthy group(4.53±2.10ng/L)and stable coronary heart disease group(22.47±4.22 ng/L),the difference was statistically significant(All P<0.05).(3)The serum IL-11 concentration in patients with acute myocardial infarction within 12 hours of admission was positively correlated with LVEDV 3days after admission in the AMI group(r value=0.444,P value=0.002),and positively correlated with LVEDD(r value=0.405,P value= 0.005),negatively correlated with LVEF(r value =-0.612,P value = 0.000);serum IL-11 concentration within 12 hours of admission to patients with acute myocardial infarction was positively correlated with LVEDV at the end of follow-up(6months)in the AMI group(r value =0.707,P value=0.000),positively correlated with LVEDD(r value=0.795,P value=0.005),and negatively correlated with LVEF(r value=-0.719,P value=0.000).(4)The serum IL-11 concentration in patients with acute myocardial infarction at the plateau stage(represented at the end of follow-up)was positively correlated with LVEDV(r value=0.728,P value=0.000)and positively correlated with LVEDD(r value=0.802,P value=0.000),negatively correlated with LVEF(r value =-0.765,P value = 0.000);the concentration of IL-11 at the4 time points of 1 week,2 weeks,1 month,and 3 months after AMI in patients with AMI Both LVEDV and LVEDD were positively correlated and negatively correlated with LVEF.(5)The serum IL-11 concentration in the ventricular remodeling group of AMI patients was significantly higher than that of the non-ventricular remodeling group within 12 hours after admission.The differences were statistically significant.Conclusions: Serum IL-11 in patients with acute myocardial infarction showed a high level of expression,peaked at 12 hours after admission,and maintained a high level of expression until 2 weeks,and gradually decreased from the third week,and continued to show a low level of expression by January.IL-11 levels are correlated with left ventricular remodeling and left ventricular function.IL-11 level may be an effective indicator for predicting left ventricular remodeling in patients with acute myocardial infarction. |
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