急性冠状动脉综合征相关炎性因子的临床价值  

The diagnostic value of IL-6,NT-proBNP and hs-CRP for acute coronary syndromes patients

作　　者：王苏梦[1] 张明威[1] 宋令雄 汪俊军[1] 

机构地区：[1]南京军区南京总医院临床检验科,南京210000

出　　处：《检验医学与临床》2017年第14期2025-2027,共3页Laboratory Medicine and Clinic

基　　金：南京军区南京总医院青年基金资助项目(2012049)

摘　　要：目的探讨白细胞介素-6(IL-6)、N-末端B型钠尿肽前体(NT-proBNP)和超敏C反应蛋白(hs-CRP)对急性冠状动脉综合征(ACS)的临床诊断价值。方法检测41例稳定型冠心病(sCAD)(sCAD组)、56例ACS患者(ACS组)、64例健康者(健康对照组)血清IL-6、NT-proBNP和全血hs-CRP水平,并进行相关性分析。结果 IL-6、NT-proBNP、hs-CRP水平在ACS患者中分别为22.00(10.80~58.30)ng/L、205.00(107.60~653.40)pmol/L、6.65(2.00~22.47)mg/L;sCAD患者为5.95(1.50~17.65)ng/L、60.00(16.35~307.80)pmol/L、3.40(1.10~9.70)mg/L;健康者为2.97(1.51~4.40)ng/L、3.35(1.23~6.18)pmol/L、1.15(0.50~2.38)mg/L,各组IL-6、NT-proBNP、hs-CRP水平比较,差异有统计学意义(P<0.001)。ACS患者和sCAD患者IL-6与NT-proBNP、hs-CRP均呈明显正相关(r=0.542,0.527,P<0.001;r=0.521,0.478,P<0.005)。IL-6、NT-proBNP、hs-CRP受试者工作特征(ROC)曲线下面积(AUC)分别为0.967、0.988、0.847;IL-6诊断ACS的灵敏度为92.1%,特异度为95.3%,NT-proBNP的灵敏度为96.2%,特异度为89.7%,hs-CRP的灵敏度为70.8%,特异度为81.2%。结论IL-6与NTproBNP、hs-CRP可用于ACS预测,具有一定的临床诊断价值。Objective To investigate the diagnostic value of IL-6,NT-proBNP and hs-CRP for acute coronary syndromes patients.Methods Plasma IL-6,NT-proBNP,high-sensitivity C-reactive protein （hs-CRP） levels were determined in 41 ACS,56 stable CAD patients.The correlation analyses and multiple linear regression analyses were performed.Results Plasma IL-6,NT-proBNP and hs-CRP levels showed 22.00（10.80-58.30）ng/L,205.00（107.60-653.40） pmol/L,6.65（2.00-22.47）mg/L respectively,they were significantly higher than patients with CAD 5.95（1.50-17.65）,60.00（16.35-307.8）,3.40（1.10-9.70）,the healthy controls showed 2.97（1.51-4.4）ng/L,3.35（1.23-6.18）pmol/L,1.15（0.5-2.38）mg/L.IL-6 levels were positively correlated with NT-proBNP and hs-CRP in stable ACS and CAD patients（r=0.542,r=0.617,P〈0.001;r=0.521,r=0.478,P〈0.005）.Receiver operating characteristics（ROC） curve was used to analyze the diagnostic value in diagnoses of ACS.The area of IL-6,NT-proBNP and hs-CRP under the curve were 0.967,0.988 and 0.847;The sensitivity of IL-6 was 92.1%,specificity was 95.3%;The sensitivity of NT-proBNP was 96.2%,specificity was 89.7%.The sensitivity of hs-CRP was 70.8%,specificity was 81.2%.Conclusion Plasma NT-proBNP,hs-CRP and RDW levels are significantly higher in ACS patients and elevated NT-proBNP levels are associate with IL-6 and hs-CRP.The test of the three biomarkers level is helpful for ACS clinical diagnosis.

关 键 词：白细胞介素-6 N-末端B型钠尿肽前体 超敏C反应蛋白 急性冠状动脉综合征 

分 类 号：R543.3[医药卫生—心血管疾病]