IL-6、IL-27与ST段抬高型心肌梗死患者冠状动脉介入治疗预后的关系
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(1.新疆医科大学第六附属医院心血管内科,新疆乌鲁木齐市 830002;2.新疆医科大学公共卫生学院, 新疆乌鲁木齐市 830000;3.新疆维吾尔自治区人民医院心血管内科,新疆乌鲁木齐市 830001)

作者简介:

王旭敏,硕士,主治医师,研究方向为冠心病介入治疗,E-mail为boom00318@163.com。通信作者赖红梅,博士,主任医师,研究方向为心肌损伤与保护机制,E-mail为laihongmei430@163.com。

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新疆维吾尔自治区自然科学基金项目(2017D01C115)


Impacts of interleukin-6 and interleukin-27 on the prognosis of patients with ST-segment elevation myocardial infarction underwent percutaneous coronary intervention
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1.Department of Cardiology, Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830002, China;2.Institute of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830000, China;3.Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China)

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    摘要:

    目的 探讨白细胞介素6(IL-6)、白细胞介素27(IL-27)与急性ST段抬高型心肌梗死(STEMI)患者冠状动脉介入治疗预后的关系。方法 纳入2015年1月至2016年12月在新疆维吾尔自治区人民医院接受冠状动脉介入治疗的初发STEMI患者,收集其临床资料及介入治疗前血液标本,采用酶联免疫吸附法检测血浆IL-6和IL-27水平。根据患者术后一年是否发生主要不良心血管事件(MACE)将其分为对照组和MACE组,利用多因素Logistic回归模型和受试者工作特征(ROC)曲线分析IL-6、IL-27与MACE发生的关系及其预测价值。结果 287例初发STEMI患者,男性179例(62.4%),年龄为61.37±9.83岁,其中57例发生MACE(19.9%)。MACE组患者年龄、Gensini评分、血浆IL-6和IL-27水平以及吸烟、糖尿病、双支/多支血管病变比例均显著高于对照组患者。Logistic回归分析显示,IL-6(OR=1.72,95%CI为1.50~2.15,P<0.001)和IL-27(OR=1.24,95%CI为1.11~1.42,P=0.001)是STEMI患者介入治疗一年期MACE发生的独立危险因素。IL-6和IL-27预测MACE的曲线下面积分别为0.701和0.690。结论 IL-6和IL-27是STEMI患者冠状动脉介入治疗后一年期MACE发生的独立危险因素,对患者临床结局具有一定的预测价值。

    Abstract:

    Aim To evaluate the prognostic value of plasma interleukin-6 (IL-6) and interleukin-27 (IL-27) level in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods Patients with STEMI diagnosed first time and underwent PCI in People’s Hospital of Xinjiang Uygur Autonomous Region were consecutively enrolled from January 2015 to December 2016. Clinical data and blood samples before PCI were obtained from all patients. Plasma levels of IL-6 and IL-27 were measured by enzyme-linked immunosorbent assay. The patients were divided into two groups based on the occurrence of major adverse cardiovascular events (MACE) during 1-year follow-up after STEMI diagnosis. Logistic regression analysis was performed to evaluate the relationship between plasma IL-6 and IL-27 levels and the occurrence of MACE. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive values of IL-6 and IL-27 on the occurrence of MACE. Results Among 287 patients with STEMI, 179 (62.4%) were males and the age was 61.37±9.3,7 (19.9%) had MACE. Compared with controls, patients in MACE group were older with higher Gensini score, higher plasma IL-6 and IL-27 levels. The prevalence of smoking, diabetes, and two- or multi-vessel coronary artery disease were higher in MACE group in comparison to controls. Logistic regression analysis demonstrated that IL-6 (OR=1.2,5%CI was 1.50~2.15, P<0.001) and IL-27 (OR=1.4,5%CI was 1.11~1.42, P<0.001) were significantly independent predictors of MACE in STEMI patients undergoing PCI. The area under the ROC curve of IL-6 and IL-27 for predicting MACE were 0.701 and 0.690, respectively. Conclusion Plasma IL-6 and IL-27 levels were independent risk predictors for identifying the MACE of 1-year follow-up in patients with STEMI underwent PCI, indicating that they may help to assess the clinical outcomes for us.

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王旭敏,章恒,熊英,赖红梅. IL-6、IL-27与ST段抬高型心肌梗死患者冠状动脉介入治疗预后的关系[J].中国动脉硬化杂志,2019,27(3):221~226.

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  • 收稿日期:2018-08-02
  • 最后修改日期:2018-09-25
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  • 在线发布日期: 2019-01-28