Study On The Relationship Between Serum Interleukin-39 And Coronary Heart Disease And The Severity Of Coronary Artery Disease

Background:Coronary atherosclerotic heart disease is a kind of heart disease caused by coronary artery atherosclerosis,which leads to myocardial ischemia,hypoxia or necrosis,which is referred to as coronary heart disease(CHD).The pathological basis of coronary heart disease is atherosclerosis(AS),which is the most common atherosclerotic disease in the whole body.The pathophysiological mechanism of atherosclerosis is very complex.Previous studies suggested that atherosclerosis is a common degenerative disease,and later confirmed that inflammation is one of the most important causes of atherosclerosis.At present,more and more studies have shown that inflammatory factors play an important role in the occurrence and development of coronary heart diseasePrevious studies have found that interleukin-12(IL-12)family includes four heterodimers:IL-12,IL-23,IL-27 and IL-35,a large number of studies have shown that they can promote or inhibit inflammation,which have different effects on the occurrence and development of coronary heart disease.Interleukin-39(IL-39)is a newly discovered member of the IL-12 family.The study on the relationship between IL-39 and the severity of coronary heart disease and coronary artery disease is not clearTherefore,this paper studied the correlation between serum IL-39 level and the severity of coronary heart disease and coronary artery disease,as well as the relationship with common risk factors of coronary heart disease,and discussed the role of IL-39 in predicting the severity of coronary heart disease and coronary artery disease,so as to open up a new way for the diagnosis and treatment of coronary heart diseaseObjective:To analyze the level of serum IL-39 in patients with coronary heart disease and their different groups,and to further study the correlation between the level of serum IL-39 and the severity of coronary artery diseaseMethods:The subjects were 206 patients who were hospitalized in the Department of Cardiology,Taizhou people's Hospital from October 2018 to October 2019.According to the clinical manifestations and the results of coronary angiography,the patients were divided into coronary heart disease group(at least one coronary artery stenosis?50%)and control group(normal coronary angiography,n=72).According to the type,the CHD group was divided into stable angina pectoris(SAP)group(n=36),unstable angina pectoris(UAP)group(n=38)and acute myocardial infarction(AMI)group(n=60).According to the diseased vessels,the coronary heart disease group was subdivided into single vessel disease group(n=40),two-vessel disease group(including left main artery disease group)(n=36)and three-vessel disease group(n=58).Taking the quartile of Gensini score as the dividing point,the CHD group was subdivided into the first quartile(score?22.0,n=34),the second quartile(22.0<score?48,n=41),the third quartile(48<score?66.5,n=26)and the fourth quartile(score>66.5,n=33).They were defined as mild stenosis group,moderate stenosis group,severe stenosis group and extremely severe stenosis group.The severity of coronary artery disease was evaluated according to the number of diseased branches and Gensini score,and the concentration of serum IL-39 was measured by enzyme-linked immunosorbent assay(ELISA).Results:1.Compared with the control group,the prevalence rates of smoking,hypertension,hyperlipidemia and diabetes were higher in the CHD group,and the body mass index(BMI),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),fasting blood glucose(FPG),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)and hypersensitive C-reactive protein(hs-CRP)in the CHD group were all higher than those in the control group(P<0.01),systolic blood pressure(SBP),diastolic blood pressure(DBP)and left ventricular ejection fraction(LVEF)were lower than those in the control group(P<0.05).The level of serum IL-39 in CHD group was significantly higher than that in control group(P<0.01).2.The coronary heart disease group was further divided into stable angina pectoris group,unstable angina pectoris group and acute myocardial infarction group.With the aggravation of the clinical severity of coronary heart disease,the level of serum IL-39 increased continuously,and there was significant difference among the three groups(P<0.05).3.According to the number of diseased vessels,the patients were divided into three groups:single-vessel disease group,two-vessel disease group and three-vessel disease group.With the increase of the number of diseased vessels,the level of serum IL-39 increased,and there was significant difference in the number'of different diseased vessels(P<0.01).4.According to the quartile of Gensini score,the patients were divided into the first quartile,the second quartile,the third quartile and the fourth quartile,and then defined as mild stenosis group,moderate stenosis group,severe stenosis group and extremely severe stenosis group.With the increase of the severity of coronary artery stenosis,the level of serum IL-39 increased,except that there was no significant difference between severe and extremely severe groups(P>0.05),but there was significant difference among other subgroups(P<0.01).5.Pearson correlation analysis showed that serum IL-39 level was positively correlated with diabetes,hyperlipidemia,BMI,FPG,TC,TG,LDL-C,CK-MB,hs-CRP,Gensini score and the number of diseased blood vessels(P<0.05),but negatively correlated with LVEF(P<0.05).After partial correlation analysis,the level of serum IL-39 was positively correlated with FPG(r=0.213),LDL-C(r=0.179),hs-CRP(r=0.181)and the number of diseased vessels(r=0.433)(P<0.05),but negatively correlated with LVEF(r=-0.252)(P<0.05).6.Multiple linear regression analysis showed that FPG,LDL-C,LVEF,hs-CRP and diseased vessels entered the regression equation of serum IL-39 in patients with coronary heart disease,which were independent factors affecting serum IL-39.7.Binary logistic regression analysis showed that IL-39 was an independent risk factor for coronary heart disease,while multivariate logistic regression analysis showed that TC and LVEF were independent risk factors for the degree of coronary artery stenosis.8.The receiver operating characteristic curve(ROC curve)shows that the confidence interval of 95%of the area under the ROC curve is(0.931?0.989),indicating that IL-39 has a high predictive value for coronary heart disease.Conclusion:1.The level of serum IL-39 in patients with coronary heart disease was higher than that in normal controls,and increased with the severity of coronary artery disease.2.Serum IL-39 is an independent risk factor for coronary heart disease and has high predictive value for coronary heart disease.