血清IL-22检测在老年慢性心力衰竭诊断及预后评估中的价值

The value of seruminterleukin-22 level in diagnosing and evaluating the prognosis of chronic heart failure in elderly patients

目的:探讨血清白介素-22(IL-22)在老年慢性心力衰竭(CHF)诊断及预后评估中的价值。方法 :将2015年8月至2016年8月河池市人民医院收治的100例老年CHF患者作为研究组,按纽约心脏学会(NYHA)心功能分级分为I~Ⅳ级。另选取30例健康体检者为对照组。观察受试者血清中IL-22、心肌肌钙蛋白I(cTnI)、肌酸激脢(CK-MB)的水平,以及左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD)。结果:与对照组比较,研究组患者IL-22、cTnI、CK-MB、LVEDD、LVESD均显著升高(P<0.05),且随着NYHA分级的增加而升高,同时LVEF显著降低(P<0.05)。研究组患者血清IL-22水平与cTnI、CK-MB、LVEDD、LVESD呈正相关关系(P<0.05),与LVEF呈负相关关系(P<0.05)。受试者工作特征曲线(ROC)分析结果显示,血清IL-22诊断CHF的ROC曲线下面积为0.883;血清IL-22预测CHF的特异度为81%,灵敏度为91%。且对比不同预后CHF患者血清IL-22水平发现,心源性死亡组和心源性再住院组患者血清IL-22水平显著高于无再发事件组(P<0.05),且心源性死亡组血清IL-22水平显著高于心源性再住院组(P<0.05)。结论:血清IL-22水平可作为老年CHF诊断、危险分层及预后评估的重要指标,其对老年CHF的治疗和干预有重要意义。

Objective： To investigate the value of serum interleukin-22 （IL-22） level in diagnosis and progno sis prediction of chronic heart failure （CHF） in elderly patients. Methods： 100 elderly patients with CHF （NYHA classification I-IV） treated in our hospital from August 2015 to August 2016 were enrolled as a research group. 30 healthy subjects were also selected as a control group. The serum IL-22, cardiac troponin I （cTnI） and creatine kinase-MB （CK-MB） levels as well as left ventricular ejection fraction （LVEF）, left ventricular end diastolic dimension （LVEDD） and left ventricular ejection fraction （LVEF） were compared. Results： CHF patients had significantly higher levels of IL-22, cTnI, CK-MB, LVEDD and LVESD （ P 〈 0.05）. The levels of IL-22, cTnI and CK-MB increased, and LVEF decreased when NYHA class went higher （ P 〈0. 05）. The serum IL-22 level was positively correlated with cTnI, CK-MB, LVEDD and LVESD （P〈0.05）, and was negatively associated with LVEF （P G0. 05）. The area under the ROC curve of IL 22 was 0. 883, and the serum IL-22 level presented high specificity （81% and sensitivity （91%） for predicting CHF. The level of serum IL-22 in patients with cardiac death and cardiogenic re-hospitalization was significantly higher than that in patients without recurrence （ P 〈0.05）, and the level of IL-22 in patients with cardiac death was notably higher than those in patients with cardiogenic re-hospitalization （ P 〈0.05）. Conclusion： Serum IL-22 level could be a diagnostic and predictive marker for clinical outcomes of CHF in elderly patients, and it was of great significance for CHF treatment .