The Expression And Significance Of Milk Fat Globule Epidermal Growth Factor-8 In Myocardial Ischemia Reperfusion Injury

Objective:To discuss whether serum Milk fat globule epidermal growth factor-8(MFG-E8) participate in the process of myocardial ischemia reperfusion injury(MIRI) with patients of acute myocardial infarction(AMI),and the correlation between the level of MFG-E8,high-sensitivity C-reactive protein and Interleukin-6.Methods:40 cases of patients within 6 hours of onset during January 2014 and August 2014 in our Medical College in AMI under PCI were collected as AMI group and 30 cases in control group who were confirmed as healthy under coronary arteriongraphy(CAG).The two groups were in PCI or CAG just before operation,24 hours after operation,postoperative 48 hours in peripheral blood 5ml,below 80 ℃ keep in refrigerator after centrifugation.And for troponin T(c Tn T),isoenzyme of creatine kinase-MB(CK-MB),brain natriuretic Peptide(BNP),liver function,renal function,blood lipids,blood glucose monitoring on admission day,recording adverse events occurred during hospitalization(such as arrhythmia, cardiogenic sudden death).Samples were collected after,enzyme linked immunosorbent assay(ELISA) was used to detect serum level of MFG-E8,Hs-CRP and IL-6,compared at different time points on the level of each factor changes. Statistical analysis was performed using SPSS18 software.Results:(1) The serum MFG-E8 level of AMI group at each time point was lower than the corresponding time point in the control group,there was significant difference between the groups(P=0.003、P=0.006、P=0.002).In group AMI,the serum level of MFG-E8 at postoperative 24 hours were significantly elevated compared to preoperation(P=0.006),The postoperative 48 hours serum MFG-E8 level continues to rise,compared to preoperation and postoperative 24 hours,there was significant difference between the groups(P=0.005、P=0.001).The serum MFG-E8 level of control group between the three groups of preoperation,postoperative 24 hours and postoperative 48 hours,There is no statistically significant difference(P=0.067 、 P=0.059 、P=0.150).(2) The serum Hs-CRP level of AMI group at each time point were higher than the corresponding time points in control group,there was significant difference between the groups(P=0.012、P=0.006、P=0.005).The serum level of Hs-CRP in the AMI group postoperative 24 hours was significantly increased compared to preoperation(P=0.002),while it was significantly lower at postoperative 48 hours compared to 24 hours(P=0.008).However,hs-CRP in both two groups were still elevated at postoperative 48 hours compared to preoperative(P=0.005).The serum Hs-CRP level of control group between the three groups of preoperation,postoperative 24 hours and postoperative 48 hours,There is no statistically significant difference(P=0.100 、 P=0.350 、P=0.058).(3)The serum IL-6 level of AMI group at each time point were higher than the corresponding time points in control group,there was significant difference between the groups(P=0.009、P=0.003、P=0.028).In group AMI,the serum level of IL-6 at postoperative 24 hours were significantly elevated compared to preoperation(P=0.002),The postoperative 48 hours serum IL-6 level continues to rise,compared to preoperation and postoperative 24 hours,there was significant difference between the groups(P=0.003 、P=0.001).The serum IL-6 level of control group between the three groups of preoperation,postoperative 24 hours and postoperative 48 hours,There is no statistically significant difference(P=0.055、P=0.140、P=0.320).(4) The AMI group at each time point of the level of serum MFG-E8 was negatively correlated with Hs-CRP level(r=-0.774,P=0.003;r=-0.462,P=0.006;r=-0.744,P=0.008),negatively correlated with IL-6 level(r=-0.514,P=0.006;r=-0.408,P=0.005;r=-0.439,P=0.004),the level of serum Hs-CRP and IL-6 levels were positively correlated at each time point(r=0.434,P=0.003;r=0.436,P=0.008;r=0.399, P=0.001).(5) RA was observed immediately after IRA in AMI group,including 11 cases of sinus bradycardia,6 cases of ventricular premature,8 cases of atrial premature,3 cases of ventricular fibrillation,5 cases of atrioventricular block,1 cases of sinus cardiac arrest,6 cases of ventricular tachycardia.(6) According to the 24 hours after the operation of BNP is normal, the AMI group was divided into BNP abnormal group and normal BNP group,abnormal BNP compared with normal MFG-E8 levels at each time point decreased significantly(P=0.003).(7) Group AMI patients with nosocomial adverse events(heart failure,cardiogenic sudden death),patients than in patients with normal MFG-E8 levels at each time point was significantly decreased(P=0.012).Conclusion:(1) MFG-E8 is involved in the process of AMI patients in the emergency room for PCI operation in treatment of cardiac muscle during MIRI,this process may be released through inhibition of inflammatory cytokines Hs-CRP and IL-6,and participate in the process of MIRI.(2) MFG-E8 has a predictive value for the prognosis of patients with acute myocardial infarction in patients with long term.