冠心病病人白细胞数量及血清IL-6浓度变化及意义  

CHANGES AND SIGNIFICANCE OF WHITE BLOOD CELL COUNTS AND SERUM LEVEL OF INTERLEUKIN-6 IN PATIENTS WITH CORONERY HEART DISEASE

作　　者：孙婷婷[1] 张帅[2] 王元松[3] 孟子凡 刘成玉[1] 

机构地区：[1]青岛大学医学院诊断学教研室,山东青岛266021 [2]青岛大学医学院 [3]青岛大学医学院临床技能学实验室,山东青岛266021 [4]青岛大学医学院附属医院输血科,山东青岛266021

出　　处：《青岛大学医学院学报》2014年第3期233-235,238,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的 探讨冠心病（CHD）病人外周血白细胞（WBC）数量及血清白细胞介素-6（IL-6）浓度的变化及其临床意义。方法 采用血细胞分析仪和ELISA法，测定急性心肌梗死（AMI组）20例、不稳定型心绞痛（UAP组）20例、稳定型心绞痛（SAP组）20例病人外周血WBC数量及血清IL-6浓度变化，并以同期健康体检者20例作为对照。结果 CHD病人WBC数量、血清IL-6浓度明显升高，与对照组比较差异有显著性（t=3.710、6.233，P〈0.01）。AMI组WBC数量、中性粒细胞比例（NEUT%）、中性粒细胞计数（NEUT）、中性粒细胞计数/淋巴细胞计数（N/L）比值显著高于SAP组、UAP组和对照组（F=10.559～24.228，q=6.389～11.593，P＜0.01）。SAP组、UAP组、AMI组血清IL-6浓度依次升高，差异有显著性（F=29.502，q=3.751～12.005，P＜0.01）。CHD病人WBC计数、NEUT%、NEUT、N/L比值与血清IL-6浓度呈正相关（r=0.312～0.377，P＜0.05）。AMI病人WBC计数、NEUT%、NEUT、N/L比值、血清IL-6浓度的ROC曲线下面积（AUCROC）分别为0.794、0.983、0.891、0.983、0.970，对AMI诊断的灵敏度和特异度分别为0.650和0.950、0.950和0.950、0.750和0.950、1.000和0.900、1.000和0.850。UAP和SAP病人血清IL-6浓度的AUCROC分别为0.923、0.753，对SAP和UAP诊断的灵敏度和特异度分别为0.800和0.900、1.000和0.500。结论 WBC数量和血清IL-6浓度变化与冠心病的病情严重程度密切相关，且对冠心病有较高的诊断价值。Objective To explore the changes and clinical significance of white blood cell （WBC） counts and serum level of interleukin-6 （IL-6） in patients with coronary heart disease （CHD）. Methods Using blood cell analyzer and enzyme-linked immunosorbent assay. WBC counts and serum level of IL-6 were detected, respectively, in 20 patients with acute myocardial infarction （AMI）, 20 with unstable angina pectoris （UAP）, 20 with stable angina pectoris （SAP） and 20 controls. Results The WBC count and the serum IL-6 in CHD were higher than that in the controls （t=3.710,6.233;P〈0.01）. The WBC count, neutrophile ratio （NEUT%）, neutrophile count （NEUT）, neutrophile count/lymphocyte count （N/L） ratio in AMI were higher than that in UAP, SAP and controls （F=10.559-24.228,q=6.389-11.593,P〈0.01）. The levels of serum IL-6 increased in order of SAP, UAP, AMI, the differences among them were significant （F=29.502,q=3.751-12.005,P〈0.01）. In CHD, WBC count, NEUT%,NEUT,and N/L ratio were positively correlated with serum IL-6 （r=0.312-0.377,P〈0.05）. The areas under the ROC curve of WBC count, NEUT%, NEUT, N/L ratio and serum IL-6 in AMI were 0.794, 0.983, 0.891, 0.983, and 0.970, respectively. The sensitivity and specificity for diagnosis of AMI were 0.650 and 0.950, 0.950 and 0.950, 0.750 and 0.950, 1.000 and 0.900, 1.000 and 0.850, respectively. The AUCROC of serum level of IL-6 in UAP and SAP was 0.923 and 0.753, respectively. And the sensitivity and specificity for diagnosis of UAP and SAP were 0.800 and 0.900,1.000 and 0.500,respectively. Conclusion The changes of WBC count and serum level of IL-6 are closely associated with the severity of coronary heart disease, which have a higher value in the diagnosis of the disease.

关 键 词：冠状动脉疾病 白细胞计数 白细胞介素6 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]