终末期肾病腹膜透析患者血清IL-6、IL-10、iPTH、CRP水平与主要心脏不良事件的相关性  

The correlation between serum IL-6,IL-10,iPTH,CRP levels and major cardiac adverse events in patients with end-stage renal disease undergoing peritoneal dialysis

作　　者：胡倩 黄宏耀 Hu Qian;Huang Hongyao(Jinzhou Medical University,Jinzhou 121013,China;Department of Nutrition,the Second People′s Hospital of China Three Gorges University(the Second People′s Hospital of Yichang),Yichang 443000,China;Department of Clinical Laboratory,Suizhou Hospital Affiliated to Hubei University of Medicine,Suizhou 441300,China)

机构地区：[1]锦州医科大学,锦州121013 [2]三峡大学附属第二人民医院(宜昌市第二人民医院)营养科,宜昌443000 [3]湖北医药学院附属随州医院检验科,随州441300

出　　处：《中国医师杂志》2024年第8期1201-1205,共5页Journal of Chinese Physician

基　　金：宜昌市科技创新项目(A23-1-053)。

摘　　要：目的分析终末期肾病(ESRD)腹膜透析患者血清白细胞介素-6(IL-6)、IL-10、全段甲状旁腺素(iPTH)、C反应蛋白(CRP)水平与主要心脏不良事件(MACE)的相关性,并评价上述指标预测MACE发生价值。方法前瞻性选择2020年1月至2022年6月在宜昌市第二人民医院行腹膜透析(PD)的120例ESRD患者作为研究对象,均抽取肘静脉血检测血清IL-6、IL-10、iPTH、CRP水平,超声心动图测量左室射血分数(LVEF)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)等,计算心脏功能综合(Tei)指数。患者均随访至2023年6月或终点事件死亡,根据是否发生MACE分为MACE组和非MACE组,比较两组血清IL-6、IL-10、iPTH、CRP水平及LVEF、LVEDV、LVESV、Tei指数;采用Spearman分析血清IL-6、IL-10、iPTH、CRP水平与MACE发生的相关性;建立受试者工作特征(ROC)曲线,分析血清IL-6、IL-10、iPTH、CRP水平预测MACE发生的价值。结果MACE组血清IL-6、iPTH、CRP水平均高于非MACE组,差异有统计学意义(均P<0.05)。两组血清IL-10水平比较差异无统计学意义(P>0.05)。MACE组LVEF低于非MACE组,LVEDV、LVESV、Tei指数高于非MACE组,差异有统计学意义(均P<0.05)。血清IL-6、iPTH、CRP水平与MACE的发生呈正相关(r=0.937,0.895,0.699,均P<0.001);血清IL-10与MACE的发生无相关性(P=0.510)。血清IL-6、iPTH、CRP预测ESRD患者发生MACE的截断值分别为2.84 pg/ml、308.71 pmol/L、6.91 mg/L,ROC曲线下面积(AUC)(95%CI)分别为0.611(0.514~0.702)、0.542(0.481~0.619)、0.518(0.457~0.653)。结论PD患者MACE的发生与血清IL-6、iPTH、CRP水平呈正相关,IL-6、iPTH、CRP可作为PD患者MACE发生的预测指标。ObjectiveTo analyze the correlation between serum levels of interleukin-6(IL-6),IL-10,whole parathyroid hormone(iPTH),C-reactive protein(CRP)and major adverse cardiac events(MACE)in patients with end-stage renal disease(ESRD)undergoing peritoneal dialysis,and to evaluate the predictive value of these indicators for the occurrence of MACE.MethodsA prospective study was conducted on 120 ESRD patients who underwent peritoneal dialysis(PD)at the Second People′s Hospital of Yichang from January 2020 to June 2022.Blood samples were collected from the elbow vein to measure serum IL-6,IL-10,iPTH,and CRP levels.Echocardiography was used to measure left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and the comprehensive cardiac function index(Tei)was calculated.All patients were followed up until June 2023 or the endpoint event of death.They were divided into MACE group and non MACE group based on whether MACE occurred.The serum levels of IL-6,IL-10,iPTH,CRP,LVEF,LVEDV,LVESV,and Tei index were compared between the two groups;Spearman analysis was used to investigate the correlation between serum IL-6,IL-10,iPTH,CRP levels and the occurrence of MACE;We established receiver operating characteristic(ROC)curves and analyzed the value of serum IL-6,IL-10,iPTH,and CRP levels in predicting the occurrence of MACE.ResultsThe serum levels of IL-6,iPTH,and CRP in the MACE group were higher than those in the non MACE group,and the differences were statistically significant(all P<0.05).The difference in serum IL-10 levels between the two groups was not statistically significant(P>0.05).The LVEF of the MACE group was lower than that of the non MACE group,while the LVEDV,LVESV,and Tei indices were higher than those of the non MACE group,with statistically significant differences(all P<0.05).The levels of serum IL-6,iPTH,and CRP are positively correlated with the occurrence of MACE(r=0.937,0.895,0.699,all P<0.001);There was no correlation between serum IL-10

关 键 词：终末期肾病 腹膜透析 主要心血管不良事件 白细胞介素-6 白细胞介素-10 全段甲状旁腺素 C反应蛋白质 

分 类 号：R692.5[医药卫生—泌尿科学]