高敏肌钙蛋白I、IL-6及IL-8检测对主动脉瓣狭窄患者瓣膜置换术后预后的预测价值

Predictive value of high-sensitivity troponin I,IL-6 and IL-8 detection in prognosis of patients with AS after valve replacement

目的探讨血清高敏肌钙蛋白I(hs-c Tn I)、白细胞介素-6(IL-6)、IL-8水平对主动脉瓣狭窄(AS)患者瓣膜置换术后预后评估的临床价值。方法回顾性选取2016年1月至2018年1月四川省人民医院收治的120例AS患者,并选取同期60例无心脏疾病的健康体检者60例(对照组),均行血清hs-c Tn I、IL-6、IL-8检测。所有AS患者术后随访1年,统计不良事件发生情况及生存情况,以及与hs-c Tn I、IL-6、IL-8水平的关系。采用受试者工作特征曲线(ROC)分析血清hs-c Tn I、IL-6、IL-8检测预测患者预后的临床价值。结果病例组血清hs-cTnI、IL-6、IL-8水平均明显高于对照组(P <0. 05),且随着主动脉瓣狭窄程度加重,血清hs-cTnI、IL-6、IL-8水平均逐渐增高(P<0. 05)。术后随访1年,120例患者,发生不良事件55例,未发生不良事件65例;死亡24例,存活96例;发生不良事件组血清hs-c Tn I、IL-6、IL-8水平均明显高于未发生不良事件组(P <0. 05);死亡组血清hs-c Tn I、IL-6、IL-8水平亦均明显高于存活组(P <0. 05)。血清hs-c Tn I、IL-6、IL-8水平预测术后1年不良事件发生的ROC曲线下面积分别为0. 805、0. 781、0. 749,预测术后1年全因死亡的曲线下面积分别为0. 786、0. 751、0. 739。结论血清hs-c Tn I、IL-6、IL-8水平均对预测AS患者瓣膜置换术后的预后有较高价值,值得临床推广应用。

Objective To investigate the clinical value of serum high-sensitivity troponin I(hs-cTnI),interleukin-6(IL-6)and IL-8 levels in prognosis evaluation of patients with aortic stenosis(AS)after valve replacement.Methods 120 patients with AS admitted to the hospital from January 2016 to January 2018 were enrolled.60 healthy subjects without heart disease in the same period were selected(control group).All patients underwent serum hs-cTnI,IL-6 and IL-8 detection.All patients with AS were followed up for 1 year.The occurrence of adverse events and survival were statistically analyzed.The receiver operating characteristic(ROC)curve was performed to analyze the clinical value of serum hs-cTnI,IL-6 and IL-8 detection in predicting the prognosis.Results The levels of serum hs-cTnI,IL-6 and IL-8 in the case group were significantly higher than those in the control group(P<0.05).With the increase of the severity of AS,the levels of serum hs-cTnI,IL-6 and IL-8 gradually increased(P<0.05).After 1 year of follow-up,among the 120 patients,there were 55 cases with adverse events,65 cases without adverse events.24 cases died,and 96 cases survived.The levels of serum hs-cTnI,IL-6 and IL-8 in group with adverse events were significant higher than those in group without adverse events(P<0.05).The levels of serum hs-cTnI,IL-6 and IL-8 in the death group were significantly higher than those in the survival group(P<0.05).The areas under the ROC curve for predicting the occurrence of adverse events at 1 year after surgery by the levels of serum hs-cTnI,IL-6 and IL-8 were 0.805,0.781,and 0.749,respectively.The areas under the curve for predicting all-cause mortality at 1 year after surgery were 0.786.0.751 and 0.739,respectively.Conclusion The value of serum hs-cTnI,IL-6 and IL-8 levels are relatively higher in predicting the prognosis of patients with AS after valve replacement.