血清IL-6水平与药物涂层支架置入患者预后的关系

Relationship between serum IL-6 level and prognosis of patients underwent drug-eluting stent implantation

目的探究血清白介素-6(IL-6)水平对冠状动脉(冠脉)内药物涂层支架置入术的远期预后影响。方法选择2014年1月至2015年1月于柳州市中医医院心血管内科诊断为冠状动脉粥样硬化性心脏病(冠心病)且成功行药物涂层支架置入的患者246例,根据术前和术后1年IL-6水平的变化,将患者分为术后IL-6升高组(93例)和IL-6降低组(153例)。所有患者进行3年电话随访,分别比较随访1年、2年、3年生化指标及主要不良心血管事件(MACE)发生情况。结果术后1年两组间的累计不良心血管事件发生率无显著性差异(P>0.05)。术后2年,IL-6升高组累计靶病变血运重建显著高于IL-6降低组(P<0.05),而两组累计不良心血管事件发生率未见统计学差异(P>0.05)。术后3年,IL-6升高组的累计靶血管血运重建、累计不良心血管事件、累计心源性死亡发生率均显著高于IL-6降低组,差异具有统计学意义(P<0.05)。结论与血清IL-6降低组比较,冠脉药物涂层支架置入术后血清IL-6升高组的长期预后显著不佳。

Objective To investigate the effect of serum interleukin-6 (IL-6) level on long-term prognosis of intracoronary drug-eluting stent implantation. Methods A total of 246 patients who underwent drug-eluting stent implantation in our hospital from January 2014 to January 2015 were enrolled. According to the changes of IL-6 levels before and 1 year after surgery,patients were divided into two groups. The postoperative IL-6 elevation group (93 cases) and the IL-6 reduction group (153 cases). All patients underwent 3-year telephone follow-up and compared the incidence of major adverse cardiovascular events at 1 year,2 years,and 3 years. Results There was no significant difference in the incidence of cumulative adverse cardiovascular events between the two groups at 1 year postoperatively (P>0.05). At 2 years after operation,the cumulative target lesion revascularization was significantly higher in the IL-6-increased group than in the IL-6-lower group (P<0.05),but there was no statistically significant difference in the cumulative adverse cardiovascular events between the two groups (P>0.05). At 3 years after operation,the cumulative target vessel revascularization,cumulative adverse cardiovascular events,and cumulative incidence of cardiac death in the IL-6-increased group were significantly higher than those in the IL- 6-reduced group (P<0.05). Conclusion Compared with the serum IL-6-reduced group,the long-term prognosis of patients with elevated serum IL-6 after coronary stent-graft implantation was significantly poor.