白细胞介素-6和急性A型主动脉夹层患者长期预后的相关性  

Correlation between IL-6 and the Long-term Prognosis of the Patients with Acute Type A Aortic Dissection

作　　者：屈会娟[1] 杨毅宁[1] 朱嘉俊[1] 马依彤[1] 李晓梅[1] 谢翔[1] 

机构地区：[1]新疆医科大学第一附属医院,乌鲁木齐830054

出　　处：《西南军医》2015年第4期366-369,共4页Journal of Military Surgeon in Southwest China

基　　金：国家自然科学基金(81160042);教育部新世纪优秀人才支撑计划(NCET-11-1074)

摘　　要：目的探讨白细胞介素-6（IL-6）与急性A型主动脉夹层患者的长期预后关系。方法连续入选新疆医科大学第一附属医院心脏中心2012年1月-2014年2月完全符合诊断标准的A型主动脉夹层患者36例,采用酶联免疫吸附法（ELISA）双抗体夹心法检测入院时血浆IL-6水平。以随访1年死亡作为随访终点。采用ROC曲线和Cox生存回归分析IL-6对急性主动脉夹层患者死亡的预测价值。结果死亡组患者入院时IL-6高于存活组患者（18.13±4.2 vs 13.24±2.8,P=0.001）,具有统计学意义。ROC曲线分析提示,IL-6对急性主动脉夹层患者死亡具有预测价值（曲线下面积为0.822,95%置信区间=0.80~0.92,P〈0.005）,最佳临床分界点为19.09pg/m L,敏感度为84.9%,特异度为73.7%。根据IL-6判断夹层患者死亡的最佳临床分界点（19.09pg/m L）,将患者分为IL-6较低组和IL-6较高组。Cox生存回归分析显示,IL-6和急性主动脉夹层患者死亡密切相关[IL-6分组：HR（95%CI）=4.45（2.17~7.46）,P〈0.001;IL-6连续变量：HR（95%CI）=1.42（1.29~1.68）,P=0.032]。IL-6较高组和IL-6较低组的死亡率具有明显统计学差异（78.5%vs 23.6%,P〈0.001）。结论 IL-6的表达水平与急性A型主动脉夹层患者的预后具有明显相关性,IL-6〉19.09 pg/m L对急性A型主动脉夹层患者远期死亡事件具有预测价值。Objective To discuss the correlation between interleukin-6 （IL-6） and the long-term prognosis of the patients with acute type A aortic dissection. Methods 36 patients with acute type A aortic dissection in the heart center of the 1s＇ Affiliated Hospital to Xinji- ang Medical University were enrolled in the study; ELISA was applied in detecting the level of IL-6 of the patients at admission; death 1 year after follow-up was set as the end of the follow-up; receiver operating characteristic （ROC） curve and Cox hazard ratio regression were applied in analyzing the predicative value of IL-6 for the death of the patients with acute aortic dissection. Results The level of IL-6 of the patients in death group at admission was higher than that of the patients in survival group （18.13 ±4.2 vs 13.24±2.8, P=- 0.001）, the difference was of statistical significance; ROC curve analysis showed that IL-6 was of predicative value for the death of the patients with acute type A aortic dissection （the area under ROC curve was 0.822, 95% of the confidence intervals =0.80 - 0.92, P〈0.05）, and the cut-off value was 19.09 pg/mL with sensitivity= 84.9% and specificity=73.7%, according to which, the patients were divided in- to 2 groups： high IL-6 group and low IL-6 group; Cox regression analysis showed that IL-6 was closely correlated to the death of the pa- tients with acute aortic dissection （categorical data： HR （95% CI） = 4.45 （2.17-7.46）, P〈0.001; continuous variables： HR （95% CI）= 1.42 （1.29 - 1.68）, P=-0.032）; the death rates in high IL-6 group and low IL-6 group were of obvious statistical difference （78.5% vs 23.6%, P〈0.001）. Conclusions There exists an obvious correlation between IL-6 and the prognosis of the patients with acute type A aor- tic dissection, and IL-6〉19.09pg/mL is of predicative value for the late death of the patients with acute type A aortic dissection

关 键 词：白细胞介素-6 A型主动脉夹层 

分 类 号：R543.1[医药卫生—心血管疾病]