高血压病患者血清白介素6对缺血性中风诊断和辨证的临床意义探讨  

Discussion on the clinical value of serum interleukin-6 for the diagnosis and syndrome differentiation of ischemic stroke in patients with hypertension

作　　者：吴爱明[1] 赵明镜[1] 张冬梅[1] 高永红[1] 孙逸坤[1] 聂波[1] 娄利霞[1] 王硕仁[1] 

机构地区：[1]北京中医药大学东直门医院中医内科学教育部和北京市重点实验室,博士研究生100700

出　　处：《环球中医药》2015年第4期399-402,共4页Global Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)(2006CB504805)

摘　　要：目的探讨高血压病患者血清白介素6(interleukin-6,IL-6)检测对辅助缺血性中风诊断和辨证的临床意义。方法检测189例原发性高血压病患者的血清IL-6浓度。比较合并和未合并缺血性中风两个亚组的IL-6浓度差异,运用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价IL-6对辅助缺血性中风诊断的临床意义。分析不同IL-6浓度下的中医证候差异,并通过相关分析来探讨IL-6与中医证候之间的关系。结果高血压合并缺血性中风组的血清IL-6浓度[中位数(25%位数,75%位数)]显著高于未合并中风组[21.47(5.52,45.44)vs 2.92(1.68,4.67)pg/m L,P<0.01]。高血压病患者血清IL-6诊断缺血性中风的ROC曲线下面积为0.784(P<0.01),最佳临界值为10.10 pg/m L,对应的敏感度为72.1%,特异度为88.4%。与IL-6低浓度组比较,IL-6高浓度组的痰证出现率高,虚证出现率低(P<0.01)。相关分析显示,血清IL-6与痰证之间存在正相关关系(r=0.404,P<0.01)。结论高血压病患者血清IL-6浓度对辅助缺血性中风诊断和痰证辨证具有一定参考意义。Objective To observe the clinical value of detecting serum interleukin-6（ IL-6） for the diagnosis and syndrome differentiation of ischemic stroke in patients with hypertension. Methods The concentrations of serum IL-6 in 189 cases of patients with essential hypertension were detected. The differences in IL-6 concentration were compared between the hypertension group complicated with ischemic stroke and the hypertension group without ischemic stroke. The clinical value of serum IL-6 for the diagnosis of ischemic stroke was determined by using the receiver operating characteristic（ ROC） curves. Then the differences in Traditional Chinese Medicine（ TCM） syndromes under different levels of concentrations of IL-6 were analyzed,and based on the analysis,the correlation between IL-6 and TCM syndromes were further explored. Results Compared with the hypertension group without ischemic stroke,the concentration of serum IL-6 [Median（ 25 th percentile,75 th percentile） ] was significantly higher in the hypertension group complicated with ischemic stroke [21. 47（ 5. 52,45. 44） vs 2. 92（ 1. 68,4. 67） pg / m L,P〈0. 01]. The area under ROC curves in the diagnosis of ischemic stroke in patients with hypertension by means of serum IL-6 was 0. 784（ P〈0. 01）. The optimal cut-off point of IL-6 was 10. 10 pg / m L,with a corresponding sensitivityof 72. 1% and specificity of 88. 4%. Compared with the low IL-6 concentration group,the probability of occurrence of phlegm syndrome increased and the probability of occurrence of deficiency syndrome decreased in the high IL-6 concentration group（ P〈0. 01）. Furthermore the correlation analysis showed that there was a positive correlation between IL-6 and phlegm syndrome（ r = 0. 404,P〈0. 01）. Conclusion Serum IL-6 has some reference value in the diagnosis of ischemic stroke and can assist TCM in the differentiation of phlegm syndrome in patients with hypertension.

关 键 词：高血压病 白介素6 缺血性中风 中医证候 

分 类 号：R259[医药卫生—中西医结合]