| Background and Objective Acute myocardial infarction（AMI）is one of the major diseases causing disability and death in the world,which is closely related to the progression of atherosclerosis（AS）.Vascular endothelial inflammation is an important mechanism of AMI induced by AS.Previous studies have shown that the levels of interleukin IL-1β,IL-6 and tumor necrosis factor（TNF）-α in plasma of patients with acute coronary syndrome are increased,which is considered to facilitate the occurrence and development of coronary AS.These inflammatory factors can boost the structural changes and instability of atherosclerotic plaques by promoting the expression of chemokines and other inflammatory mediators,and participate in the reperfusion injury of myocardial ischemic areas.IL-22 is a characteristic cytokine secreted mainly by immune cells such as Th22.IL22 is related to inflammation and lipid metabolism,and can be used as a potential target for atherosclerosis and other diseases.We explore the correlation between plasma IL-22 level and the severity of coronary artery disease and prognosis by detecting plasma IL-22,IL-1 β,IL-6 and TNF-α in patients with AMI,combined with baseline data,SYNTAX score and the occurrence of MACCE.Methods A total of 98 AMI patients who underwent primary or emergency PCI treatment in our hospital from October 2014 to December 2016 were selected（excluding those who did not successfully receive PCI after thrombolysis,those with surgical contraindications,and those with incomplete clinical and laboratory data）,including 58 patients with STEMI and 40 patients with NSTEMI.Forty patients with normal coronary angiography in the department of cardiology in the same period were selected as the control group.The levels of plasma IL-22,IL-1β,IL-6 and TNF-α were measured by Luminex liquid chip technique.The baseline data and cytokine levels between AMI and CAG negative groups were compared and analyzed.The correlation between SYNTAX score and plasma IL-22 in patients with AMI were analysed.ROC curve is used to analyze the prediction ability of IL-22 and other indexes for medium and high SYNTAX integrals.Patients with AMI were divided into groups according to whether there were MACCE events within 5 years after discharge.SYNTAX score,age,LDL-C and c Tn I were included to carry out binary logistic regression analysis with or without MACCE events.Results 1.The baseline data showed that there was no significant difference in age,sex,and smoking among the three groups,but the incidence of family history of coronary heart disease,the levels of blood glucose,hs-CRP and BNP in STEMI and NSTEMI groups were higher than those in the CAG negative patients,while the levels of HDL-C and LVEF were lower than those in the control group.2.The median plasma levels of IL-22,IL-1β,IL-6,TNF-α and hs-CRP in STEMI group were 1074.50 pg/ml,14.37 pg/ml,52.36 pg/ml,29.75 pg/ml,respectively.The levels in the NSTEMI group were 1787.00 pg/ml,14.58 pg/ml,63.99 pg/ml,39.71pg/ml,respectively,which were higher than those in the control group 80.61 pg/ml,10.64 pg/ml,14.13 pg/ml,11.68 pg/ml,respectively.There was no significant difference between STEMI group and NSTEMI group.Plasma IL-22 levels were positively correlated with IL-1β（r=0.793,P=0.001）,IL-6（r=0.880,P<0.001）and TNF-α（r=0.840,P<0.001）.3.SYNTAX score was positively correlated with IL-22,IL-6,age and c Tn I,and negatively correlated with LVEF.Linear regression analysis was carried out with SYNTAX score as dependent variable.IL-22,age and LVEF entered the regression model（IL-22:β=0.269,P=0.023;Age:β=0.236,P=0.016;LVEF:β=-0.235,P=0.023）.4.The analysis of ROC curve showed that the area under IL-22 curve（0.760±0.053,95CI% 0.656～0.863,P=0.001）.5.Binary logistic regression analysis showed that after adjusting for confounding factors such as age,SYNTAX score and plasma IL-22 level were not risk factors of5-year MACCE in patients with AMI.Conclusion Plasma IL-22 level is related to acute myocardial infarction and can reflect the severity of coronary artery disease to a certain extent.It has a certain potential role in judging the severity of patients with AMI,but the association between IL-22 and prognosis needs to be further verified. |
