急性冠脉综合征患者血清IL-6、TNF-α、hs-CRP水平的变化及其预测并发类风湿性关节炎的效能  

Changes in serum IL-6,TNF-α,hs-CRP levels in patients with acute coronary syndrome and their predictive efficacy for concurrent rheumatoid arthritis

作　　者：钱鹏 李宗州 QIAN Peng;LI Zong-zhou(Department of Clinical Laboratory,Henan Provincial Workers'Hospital,Zhengzhou 450002,Henan,CHINA)

机构地区：[1]河南省职工医院检验科,河南郑州450002

出　　处：《海南医学》2025年第4期517-521,共5页Hainan Medical Journal

基　　金：河南省科技发展计划项目(编号:192102320061)。

摘　　要：目的探讨急性冠脉综合征患者白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)水平的变化及其预测并发类风湿性关节炎的效能。方法回顾性分析2022年1月至2023年12月河南省职工医院78例确诊为急性冠脉综合征患者的临床资料,将其中38例并发类风湿性关节炎患者纳入观察组,40例未并发类风湿性关节炎患者纳入对照组。比较两组患者的一般临床资料和血清IL-6、TNF-α、hs-CRP水平;采用多因素Logistic回归分析影响急性冠脉综合征患者发生类风湿性关节炎的因素;采用受试者工作特征(ROC)曲线评估血清IL-6、TNF-α、hs-CRP对急性冠脉综合征患者发生类风湿性关节炎的评估价值。结果两组患者的年龄、BMI、性别、吸烟史、糖尿病、高血压、白细胞计数(WBC)、胆固醇(TC)、三脂酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较差异均无统计学意义(P>0.05);观察组患者的尿酸、肌酐、同型半胱氨酸(Hcy)水平分别为(339.54±46.77)μmol/L、(66.21±13.66)μmol/L、(14.82±3.66)μmol/L,明显高于对照组的(306.39±42.66)μmol/L、(59.54±14.28)μmol/L、(12.06±3.88)μmol/L,差异均有统计学意义(P<0.05)。观察组患者的血清IL-6、TNF-α、hs-CRP水平分别为(63.59±7.26)pg/mL、(9.65±2.69)pg/mL、(27.29±4.29)pg/mL,明显高于对照组的(52.37±5.67)pg/mL、(6.06±1.37)pg/mL、(20.81±3.12)pg/mL,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,尿酸、肌酐、Hcy、IL-6、TNF-α、hs-CRP均为急性冠脉综合征患者发生类风湿性关节炎的危险因素(P<0.05)。ROC曲线分析结果显示,血清IL-6、TNF-α、hs-CRP及三者联合对急性冠脉综合征患者发生类风湿性关节炎进行预测的灵敏度分别为55.26%、84.21%、76.32%、97.37%,特异度分别82.12%、85.00%、90.00%、95.50%,曲线下面积(AUC)分别为0.800、0.881、0.900、0.981;且IL-6、TNF-α、hs-CRP三者�Objective To explore the changes in levels of interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)in patients with acute coronary syndrome and their predic-tive efficacy for concurrent rheumatoid arthritis.Methods A retrospective analysis was conducted on the clinical da-ta of 78 patients diagnosed with acute coronary syndrome at Henan Provincial Workers'Hospital from January 2022 to December 2023.Among them,38 patients with concurrent rheumatoid arthritis were included in the observation group,and 40 patients without concurrent rheumatoid arthritis were included in the control group.The general clinical data of two groups of patients were compared,as well as the serum levels of IL-6,TNF-α,and hs-CRP.Multiple logistic regres-sion analysis was used to investigate the factors influencing the occurrence of rheumatoid arthritis in patients with acute coronary syndrome.Receiver Operating Characteristic(ROC)curve was used to evaluate the value of serum IL-6,TNF-α,and hs-CRP in assessing the occurrence of rheumatoid arthritis in patients with acute coronary syndrome.Results There was no significant difference in age,BMI,gender,smoking history,diabetes,hypertension,white blood cell count(WBC),cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipo-protein cholesterol(LDL-C)between the two groups(P>0.05).The levels of uric acid,creatinine,and homocysteine(Hcy)in the observation group were(339.54±46.77)μmol/L,(66.21±13.66)μmol/L,and(14.82±3.66)μmol/L,which were significantly higher than(306.39±42.66)μmol/L,(59.54±14.28)μmol/L,and(12.06±3.88)μmol/L in the control group(P<0.05).The serum levels of IL-6,TNF-α,and hs-CRP in the observation group were(63.59±7.26)pg/mL,(9.65±2.69)pg/mL,and(27.29±4.29)pg/mL,which were significantly higher than(52.37±5.67)pg/mL,(6.06±1.37)pg/mL,and(20.81±3.12)pg/mL in the control group(P<0.05).Multivariate logistic regression analysis showed that uric acid,creati-nine,Hcy,IL-6,TNF-α,and h

关 键 词：急性冠脉综合征 类风湿性关节炎 白细胞介素6 肿瘤坏死因子Α 高敏C反应蛋白 临床意义 

分 类 号：R541.4[医药卫生—心血管疾病]