RLP-C水平、TyG指数及IL-21水平与急性心肌梗死心肌缺血再灌注损伤及心室重构的相关性分析

Correlation analysis of RLP-C concentration, TyG index and IL-21 level with myocardial ischemia-reperfusion injury and ventricular remodeling in acute myocardial infarction

摘要:

目的 探讨血清残粒脂蛋白胆固醇（RLP-C）水平、甘油三酯-葡萄糖（TyG）指数及白细胞介素-21（IL-21）水平与急性心肌梗死（AMI）心肌缺血再灌注损伤及心室重构相关指标的相关性。方法 选取2022年9月—2024年2月于新疆医科大学第五附属医院心内科收治的AMI患者240例，按照行经皮冠状动脉介入治疗期间是否发生心肌缺血再灌注损伤将患者分为再灌注损伤组和非再灌注损伤组。比较两组患者的临床资料；采用酶联免疫吸附试验检测IL-21水平；采用多因素一般Logistic回归分析影响AMI患者发生心肌缺血再灌注损伤的危险因素；采用Pearson法分析RLP-C、TyG指数及IL-21与心肌缺血再灌注损伤及心室重构指标的相关性。结果 再灌注损伤组的RLP-C水平、TyG指数和IL-21水平高于非再灌注损伤组（P <0.05）。两组患者左室舒张末期内径、室间隔厚度、左室后壁厚度、左室射血分数比较，差异均有统计学意义（P <0.05）。多因素一般Logistic回归分析结果显示，RLP-C ［O^R =1.445（95% CI：1.010，2.067）］、TyG指数［O^R =3.355（95% CI：1.964，5.731）］和IL-21 ［O^R =1.028（95% CI：1.017，1.040）］是心肌缺血再灌注损伤的独立危险因素（P <0.05）。RLP-C水平与TyG指数呈正相关（r =0.214，P =0.043），RLP-C水平与IL-21水平呈正相关（r =0.571，P =0.000），TyG指数与IL-21水平呈正相关（r =0.588，P =0.000）。TyG指数与左室后壁厚度呈正相关（r =0.237，P =0.000），TyG指数与左室射血分数呈负相关（r =-0.304，P =0.000）；IL-21与室间隔厚度呈正相关（r =0.228，P =0.000），IL-21与左室后壁厚度呈正相关（r =0.231，P =0.000），IL-21与左室射血分数呈负相关（r =-0.304，P =0.000）。结论 RLP-C、TyG指数、IL-21是AMI患者发生心肌缺血再灌注损伤的独立危险因素，与心脏重构相关指标有相关性，可作为新的预测指标。

Abstract:

Methods A total of 240 patients with AMI who were admitted to the Department of Cardiology of the Fifth Affiliated Hospital of Xinjiang Medical University from September 2022 to February 2024 were selected, and the patients were divided into reperfusion injury group and non-reperfusion injury group according to whether myocardial ischemia reperfusion injury occurred during percutaneous coronary intervention. The clinical data of the two groups were compared; Enzyme-linked immunosorbent assay was used to detect the level of IL-21. Multivariate general logistic regression analysis was used to analyze the independent risk factors for myocardial ischemia-reperfusion injury in patients with AMI. Pearson correlation analysis was used to evaluate the relationship between RLP-C, TyG index, IL-21, and indicators of myocardial ischemia-reperfusion injury and ventricular remodeling.Results The levels of RLP-C, TyG index, and IL-21 in the reperfusion injury group were higher than those in the non-reperfusion injury group (P <0.05). There were statistically significant differences in left ventricular end-diastolic diameter, ventricular septal thickness, left ventricular posterior wall thickness, and left ventricular ejection fraction between the two groups (P <0.05). RLP-C [O^R =1.445 (95% CI: 1.010, 2.067)], TyG index [O^R =3.355 (95% CI: 1.964, 5.731)], and IL-21 [O^R =1.028 (95% CI: 1.017, 1.040)] were independent risk factors for myocardial ischemia-reperfusion injury in patients with AMI (P <0.05). RLP-C level was positively correlated with TyG index (r = 0.214, P = 0.043), RLP-C level was positively correlated with IL-21 level (r = 0.571, P = 0.000), and TyG index was positively correlated with IL-21 level (r = 0.588, P = 0.000). The TyG index was positively correlated with the thickness of the posterior wall of the left ventricle (r = 0.237, P = 0.000), and the TyG index was negatively correlated with the ejection fraction of the left ventricle (r = -0.304, P = 0.000). IL-21 was positively correlated with ventricular septal thickness (r = 0.228, P = 0.000), IL-21 was positively correlated with left ventricular posterior wall thickness (r = 0.231, P = 0.000), and IL-21 was negatively correlated with left ventricular ejection fraction (r = -0.304, P = 0.000).Conclusion RLP-C, TyG index, and IL-21 are independent risk factors for myocardial ischemia-reperfusion injury in patients with AMI, which are related to ventricular remodeling and can be used as new predictors.Objectiv e To investigate the correlation of serum residual lipoprotein-cholesterol (RLP-C) level, triglyceride-glucose (TyG) index and interleukin-21 (IL-21) level with indices related to myocardial ischemia-reperfusion injury and ventricular remodeling in acute myocardial infarction (AMI).