NT-proBNP及IL-8水平与老年心绞痛患者心功能及心血管不良事件的相关性分析  

Correlation of NT-proBNP and IL-8 levels with cardiac function and adverse events in elderly patients with angina pectoris

作　　者：齐贵彬 高建步 张永杰[1] 王星[1] 彭小荷 李婷[1] 李京倡 刘琳 Qi Guibin;Gao Jianbu;Zhang Yongjie;Wang Xing;Peng Xiaohe;Li Ting;Li Jingchang;Liu Lin(The Affiliated Nanyang Central Hospital of Henan University,Nanyang 473009,Henan,China)

机构地区：[1]河南大学附属南阳市中心医院,河南南阳473009

出　　处：《临床心身疾病杂志》2023年第5期7-12,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20191464)。

摘　　要：目的探讨N末端B型钠尿肽前体(NT-proBNP)、白细胞介素8(IL-8)水平与老年不稳定型心绞痛患者心功能及心血管不良事件的相关性。方法将224例老年不稳定型心绞痛患者根据入院即刻血浆NT-proBNP水平四分位数分为1分位组(53例),2分位组(55例),3分位组(58例),4分位组(58例);又根据血清IL-8水平分为IL-8阳性组103例,IL-8阴性组121例。入组患者均予以常规对症治疗,随访12个月统计心血管事件发生率。比较不同NT-proBNP水平组、IL-8阴性与阳性组患者的体质量指数、血压、心率、总胆固醇(TC)、低密度脂蛋白(LDL)、血肌酐、左室射血分数(LVEF)及心血管不良事件发生情况。指标间的相关性采用Spearman相关分析;绘制受试者工作特征曲线分析NT-proBNP、IL-8对老年不稳定型心绞痛患者心血管不良事件的预测价值。结果不同NT-proBNP水平组患者LVEF、心功能分级比较,差异有统计学意义(P<0.01);NT-proBNP水平1~2分位组心血管事件总发生率低于3~4分位组,差异有统计学意义(P<0.05)。IL-8阳性组与IL-8阴性组患者TC、LDL、LVEF、心功能分级、心血管不良事件总发生率比较,差异有统计学意义(P<0.05或0.01)。Spearman相关分析显示,入院即刻NT-proBNP水平与LVEF呈负相关,与心功能分级呈正相关(r=-0.681、0.738,P<0.01);IL-8水平与LVEF呈负相关,与心功能分级呈正相关(r=-0.708、0.762,P<0.01);NT-proBNP与IL-8水平无相关性(r=0.172,P>0.05)。受试者工作特征曲线显示,NT-proBNP与IL-8对老年不稳定型心绞痛患者心血管不良事件发生均具有较高的预测价值,二者联合检测的预测价值更高(曲线下面积为0.829),灵敏度和特异度也高于各指标单独检测。结论入院即刻血浆NT-proBNP、血清IL-8水平与老年不稳定型心绞痛患者心功能及心血管不良事件的发生有一定联系,且NT-proBNP与IL-8无交叉性,两者联合检测对心血管不良事件的预测价值更高。Objective To explore the correlation of NT-proBNP and interleukin-8(IL-8)levels with cardiac function and adverse events in elderly patients with unstable angina pectoris(UAP).Methods A total of 224 elderly UAP patients were assigned to quartile 1(Q1,n=53),2(Q2,n=55),3(Q3,n=58)and 4(Q4,n=58)group according to the quartiles of plasma NT-proBNP levels immediately after admission;they were divided into serum IL-8 positive(n=103)and negative(n=121)group according to IL-8 levels.(IL-8≥60 ng·L^(-1)),and 121 cases of IL-8 negative group(IL-8<60 ng·L^(-1)).They were received routine symptomatic treatment,followed up for 12 months,and the incidences of adverse e vents counted.Such indexes were compared as body mass indexes(BMIs),blood pressures,heart-rates,total cholesterol(TC),low density lipoprotein(LDL),creatinine,left ventricular ejection fractions(LVEF)and cardiovascular adverse events among the groups.Inter-indictor correlations were analyzed u sing Spearman correlation analysis;predictive values of NT-proBNP and IL-8 to cardiovascular adverse e vents of elderly UAP patients were analyzed by drawing the Receiver Operating Characteristic(ROC)curve.Results Differences in the LVEF,cardiac functional grading among groups of different NT-proBNP levels were statistically significant(P<0.01).Total incidences of cardiovascular events were lower in Q1 and 2 than Q3 and 4 group,differences were statistically significant(P<0.05).Differences in TC,LDL,LVEF,cardiac functional grading and the total incidences of cardiovascular events between IL-8 positive and negative group were statistically significant(P<0.05 or 0.01).Spearman correlation analysis showed that NT-proBNP levels were negatively related to the LVEF immediately after admission and positively to cardiac functional grading(r=-0.681,0.738;P<0.01);IL-8 levels were negatively related to the LVEF immediately after admission and positively to cardiac functional grading(r=-0.708,0.762;P<0.01);there was no correlation between NT-proBNP and IL-8 levels(r=0.172,P>0.05).The

关 键 词：心绞痛 不稳定型 N末端B型钠尿肽前体 白细胞介素8 心功能 不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]