| Objective To analyze the characteristic of some important clinical indicators, including carotid artery intima-middle thickness(IMT), peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of acute coronary syndrome(ACS) patients. On the other hand, to explore the correlation of those indicators with coronary lesions degree and its stability. Even to investigate the correlation between those indicators and major adverse cardiac events(MACE), and further to evaluate the value of those indicators in early prediction and prognosis judgement of ACS patients with diabetes(DM) in clinic.Materials and Methods 1.This study enrolled 210 ACS patients who had received Coronary Arteriography(CAG) examination from May 2014 to April 2015, aged 60±15 and had course of desease beyond 3 years.Among them, 60 cases had DM.Meanwhile, 60 cases who had DM were selected as DM group,60 cases of healthy people who received physical health examination were selected as the control group. 2.Enrolled 114 ACS patients with diabetes who had received CAG examination from May 2014 to April 2015, aged 60±15 and had course of desease beyond 3 years.Among them,39 patients with acute myocardial infarction(AMI group),37 patients with unstable angina pectoris(UAP group),38 patients with stable angina pectoris(SAP group),38 cases who had DM were selected as DM group and 40 coronary angiography negative subjects were taken as controls(Control group).3.Enrolled 70 ACS patients with diabetes who had received CAG examination from May 2014 to April 2015, aged 60±15 and had course of desease beyond 3 years. According to the occurrence of MACE during their hospital were divided into MACE groups(n = 13) and without MACE group(n = 57).Carotid artery IMT was determined by color doppler ultrasonography. The levels of Fib in peripheral blood were detected by solidification method and serum hs-CRP was detected by immune turbidimetric method. Immune turbidimetric method and enzyme-linked immunosorbent assay(ELISA) were used to measure the concentrations of serum IL-18 and MMP-9 respectively. The CAG results, complications and in-hospital mortality of ACS patients were also collected and analyzed.Results 1.Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS patients were significantly increased compared with healthy control(P<0.01).A comparison of those clinical indicators of ACS patients between with DM group and without 2 diabetes group showed a significant increase in ACS patients with DM group. Carotid artery IMT, plasma Fib, serum IL-18, MMP-9 and Gensini score in ACS patients were positively correlated.The incidence of multi-vessel diseases of coronary artery was more frequent in ACS patients with DM versus without DM( 61.7% vs 38.3%), while one or two vessel diseases of coronary artery was much more common in ACS patients without DM(61.7% vs 38.3%). The Gensini score of ACS patients with DM group was much higher than that of ACS patients without DM group(P < 0.01); Severe and extremely severe lesions occurred more frequently in ACS patients with DM group(73.3% vs 26.7%),while mild-to-moderate lesions occurred more frequently in ACS patients without DM group(56.7% vs 43.3%). 2.The levels of serum IL-18, MMP-9, plasma Fib in triple branch lesions group were significantly higher than them in single branch lesion group and double branch lesions group(P<0.05), the levels of serum IL-18, MMP-9, plasma Fib in extremely severe lesion group were significantly higher than mild lesion group, moderate lesions and severe lesion group(P<0.05,P<0.01). 3.Peripheral blood Fib levels, serum IL-18 and MMP-9 concentrations were significantly higher in ACS patients with MACEs compared to ACS patients without MACEs.Peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS diabetes mellitus extend the downward trend with the treatment time after standardized treatment show time-effect relationship.Conclusion 1.Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentration and serum MMP-9 concentrations have great potential to become effective clinical indicators, which could be used to determine the risk degree and short-term prognosis of ACS patients with DM. 2.The levels of carotid artery IMT,serum IL-18, MMP-9, plasma Fib are closely with ACS DM patients and severity of coronary lesions. 3.Carotid artery IMT, serum IL-18, MMP-9, plasma Fib had clinical significance for the treatment of ACS with DM and short-term prognosis instructive. |
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