血清25(OH)D_(3)、IL-6在老年冠心病并发衰弱综合征诊断中的价值  

Diagnostic value of serum 25(OH)D_(3) and IL-6 in senile coronary heart disease complicated with frailty syndrome

作　　者：马树灿 李茹 刘智芬 肖红 英俊岐 MA Shucan;LI Ru;LIU Zhifen;XIAO Hong;YING Junqi(The First Department of Geriatrics,Hengshui People's Hospital,Hengshui 053000,China;不详)

机构地区：[1]衡水市人民医院老年医学一科,河北衡水053000 [2]衡水市人民医院中医科

出　　处：《山东医药》2022年第22期24-28,共5页Shandong Medical Journal

基　　金：河北省中医药管理局科研计划项目(2020540)。

摘　　要：目的探讨血清25-羟维生素D_(3)[25(OH)D_(3)]、白细胞介素-6(IL-6)在老年冠状动脉粥样硬化性心脏病(CHD)并发衰弱综合征诊断中的价值。方法选择381例老年CHD患者为研究对象,根据Fried衰弱表型评分将患者分为衰弱组(133例)和非衰弱组(248例)。收集患者临床资料,采用电化学发光法检测血清25(OH)D_(3),酶联免疫吸附试验测IL-6;采用多因素Logistic回归分析影响老年CHD患者并发衰弱综合征的相关因素,采用受试者工作特征曲线分析25(OH)D_(3)、IL-6诊断老年CHD患者并发衰弱综合征的价值。结果衰弱组年龄、受教育年限比较差异有统计学意义(P均<0.05),女性、近1年内跌倒史、多重用药史、有营养不良风险、肌少症、焦虑、抑郁比例、血肌酐、IL-6、B型脑钠肽水平、CCI指数高于非衰弱组(P均<0.05),白蛋白、25(OH)D_(3)水平低于非衰弱组(P均<0.05)。年龄高、近1年内跌倒史、CCI指数高、焦虑、肌少症、IL-6水平高是老年CHD患者并发衰弱综合征的危险因素(P均<0.05),25(OH)D_(3)水平高是老年CHD患者并发衰弱综合征的保护因素(P<0.05)。联合25(OH)D_(3)、IL-6诊断老年CHD患者并发衰弱综合征的曲线下面积为0.907,高于25(OH)D_(3)、IL-6单独诊断(P均<0.05)。结论年龄高、近1年内跌倒史、CCI指数高、焦虑、肌少症、IL-6水平高是老年CHD患者并发衰弱综合征的危险因素,25(OH)D_(3)水平高是保护因素;25(OH)D_(3)、IL-6在诊断老年CHD患者并发衰弱综合征方面有较高价值。Objective To investigate the value of serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)]and interleukin-6(IL-6)in diagnosis of senile coronary heart disease(CHD)complicated with frailty syndrome.Methods Totally 381 elderly patients with CHD were selected as the subjects.According to Fried frailty phenotype score,the patients were divided into frailty group(133 cases)and non-frailty group(248 cases).Clinical data were collected.Electrochemiluminescence was used to detect serum 25(OH)D_(3),and enzyme-linked immunosorbent assay was used to detect IL-6 levels.Multivariate Logis⁃tic regression was used to analyze the influencing factors for elderly CHD patients complicated with frailty syndrome.The re⁃ceiver operating characteristic(ROC)curve was used to analyze the value of 25(OH)D_(3) and IL-6 in the diagnosis of frailty syndrome in elderly CHD patients.Results Statistically significant differences were found in the age and years of educa⁃tion between the frailty group and the non-frailty group(both P<0.05).The proportion of female,fall history within the past 1 year,the history of multiple medications,the risk of malnutrition,sarcoma,anxiety,depression ratio,serum creati⁃nine(SCR),interleukin-6(IL-6),B-type brain natriuretic peptide(BNP)level and CCI index were higher,and the lev⁃els of albumin and 25(OH)D_(3) were lower in the frailty group than in the non-frailty group(all P<0.05).High age,fall history within the past 1 year,high CCI index,anxiety,sarcopenia and IL-6 were risk factors for frailty syndrome in elder⁃ly patients with CHD(all P<0.05),and 25(OH)D_(3) was a protective factor for frailty syndrome in elderly patients with CHD(P<0.05).The area under the curve of 25(OH)D_(3) combined with IL-6 in the diagnosis of frailty syndrome in elderly patients with CHD was 0.907,which was higher than that of 25(OH)D_(3) and IL-6 alone(both P<0.05).Conclusions High age,fall history within the past 1 year,high CCI index,anxiety,sarcopenia and IL-6 are risk factors for frailty syn⁃drome in elderly patients with CH

关 键 词：衰弱综合征 冠状动脉粥样硬化性心脏病 25-羟维生素D_(3) 白细胞介素-6 

分 类 号：R541.4[医药卫生—心血管疾病]