血清白介素6水平对急性冠状动脉综合征患者冠状动脉微血管障碍的诊断价值  

The diagnostic value of serum il-6 expression to coronary microvascular dysfunction in patients with acute coronary syndrome

作　　者：贾军正[1] 王安杏 徐楷[1] JIA Junzheng;WANG Anxing;XU Kai(Department of Cardiovascular Medicine,Baoji Traditional Chinese Medicine Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市中医医院心血管二科

出　　处：《心肺血管病杂志》2019年第11期1106-1109,1142,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨血清IL-6水平对急性冠状动脉综合征患者微血管障碍的预测价值。方法:评估93例接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者微血管功能状态。使用Elisa法检测ACS患者血清中IL-6水平。以微血管功能障碍(MVD)为主要观察指标,并将微循环阻力指数(IMR)≥30定义为重度MVD。使用Pearson相关性分析比较血清IL-6水平与c Tn I和IMR之间的相关性。通过单因素及多因素Logistic回归分析确定MVD的预测因子。结果:将研究对象的临床基本资料及血管造影术特征,依据IL-6表达情况将患者分为高IL-6表达组(50例)以及低IL-6表达组(43例)。IL-6高表达组患者PCI术前IMR水平显著高于低IL-6表达组[(33.5±12.4)vs.(18.3±12.3)μg/L,P<0.001]。高IL-6表达组cTnI峰值显著高于低IL-6组(P<0.001)。Pearson相关性分析显示血清IL-6水平与PCI术前IMR值呈现明显正相关(r=0.892,P<0.001),并且血清IL-6水平与c Tn I峰值呈明显正相关(r=0.493,P<0.001)。单因素及多因素Logistic分析显示血清IL-6>33μg/L(OR=7.119,95%CI:3.204~14.328,P<0.001)是影响MVD发生的危险因素。ROC曲线结果指出血清IL-6水平对于鉴别重度MVD患者的诊断价值为0.883,敏感性为86%,特异性为96%。结论:IL-6可作为评估MVD的标志物,将其纳入风险预测模型中,可以提高识别高风险患者的识别能力,有助于临床医生更有前瞻性的制定治疗方案。Objective:To investigate the predictive value of serum IL-6 expression level in microvascular disorders in patients with ischemic cardiomyopathy.Methods:Microvascular function status was assessed in 93 patients undergoing percutaneous coronary intervention(PCI).The level of IL-6 expression in the serum of the study subjects was measured using the Elisa method.Microvascular dysfunction(MVD)was set as the main observation index,and the microcirculation resistance index(IMR)≥30 was defined as severe MVD.Correlation between serum IL-6 levels and cTnI and IMR was compared by Pearson correlation analysis.Independent predictors of MVD were determined by univariate and multivariate Logistic regression analysis.Results:The clinical data and angiographic features of the subjects were divided into high IL-6 expression group(50 cases)and low IL-6 expression group(43 cases)according to IL-6 expression level.Pre-PCI IMR levels in the IL-6 high expression group significantly higher than in low IL-6 expression group[(33.5±12.4)vs.(18.3±12.3)μg/L,P<0.001].The peak c Tn I content in the high IL-6 expression group was significantly higher than that in the low IL-6 group(P<0.05).Pearson correlation analysis showed that serum IL-6 levels were positively correlated with preo-PCI IMR values(r=0.892,P<0.001),and also positively correlated with c Tn I peaks(r=0.493,P<0.001).Univariate and multivariate Logistic analysis showed that serum IL-6>33μg/L(OR=7.119,95%CI:3.204-14.328,P<0.001)was an independent risk factor for MVD development.The ROC curve result indicate that serum IL-6 levels have a diagnostic value of 0.883 for patients with severe MVD,a sensitivity of 86%,and a specificity of 96%.Conclusions:IL-6 may be used as a marker to evaluate MVD.Incorporating it into the risk prediction model can improve the recognition ability of identifying high-risk patients and help clinicians to develop more forward-looking treatment plans.

关 键 词：炎症 白介素6 微血管功能障碍 缺血性心脏病 

分 类 号：R54[医药卫生—心血管疾病]