血清IL-27水平对急性冠状动脉综合征患者心脏事件的预测价值

Predictive Effect of Serum Interleukin-27 Level on Cardiac Events in Patients with Acute Coronary Syndrome

目的探讨血清白细胞介素-27(IL-27)水平对急性冠状动脉综合征(ACS)的远期预后和心脏重构的预测价值。方法纳入75例发生主要心血管不良事件(MACE)的ACS患者为不良事件组,并以同期75例无MACE发生的ACS患者为对照组。通过ELISA法检测两组患者的入院时血清IL-27水平,并比较血清IL-27水平与MACE发生、左心功能参数的相关性。结果不良事件组的血清IL-27水平[12. 57(10. 26~15. 56) ng/m L]显著高于对照组[9. 45(7. 56~11. 79) ng/m L,P <0. 05]。血清IL-27对MACE发生的预测阈值为11. 30ng/m L,灵敏度为78. 38%、特异度为86. 32%。多因素Logistics回归分析显示血清IL-27升高对ACS患者一年内发生MACE的独立预测因素(OR=2. 38,95%CI:1. 46~5. 33,P <0. 05)。基线IL-27水平与ACS患者随访一年时的左心室射血分数呈负相关(r=-0. 20,P <0. 05)、但与左心室舒张末期容积、左心室内径、左心室质量参数和左心房容积指数等呈正相关(r=0. 22~0. 37,P <0. 05)。结论 ACS患者血清IL-27水平的升高与远期预后不良和左心功能减弱有关。

Objective To investigate the predictive value of serum interleukin-27( IL-27) level in the long-term prognosis and cardiac remodeling of acute coronary syndrome( ACS) patients. Methods 75 ACS patients with major cardiovascular events( MACE) were included in the adverse group,and another 75 patients ACS without MACE were included in the control group. Serum IL-27 levels at admission were measured by ELISA in both groups,and the correlation between serum IL-27 for MACE occurrence and left ventricular function parameters were compared. Results The serum IL-27 level in the adverse group[12. 57( 10. 26 ~ 15. 56) ng/m L]was significantly higher than that in the control group [9. 45( 7. 56 ~ 11. 79) ng/m L,P <0. 05]. The predicted threshold of serum IL-27 for MACE was 11. 30 ng/ml,with the sensitivity of 78. 38% and the specificity of 86. 23%. Multivariate logistic regression analysis confirmed an increase in serum IL-27( OR = 2. 38,95% CI: 1. 46 ~ 5. 33,P < 0. 05) for independent predictors of MACE in ACS patients within one year. Baseline IL-27 levels were negatively correlated with left ventricular ejection fraction at 1 year of follow-up in ACS patients( r =-0. 20,P < 0. 05),but with left ventricular end-diastolic volume,left ventricular internal diameter,left ventricular mass parameters and left atrial volume index were positively correlated( r = 0. 22 ~ 0. 37,P < 0. 05). Conclusions Elevated serum IL-27 levels in patients with ACS are associated with poor prognosis and decreased left ventricular function in long-term follow up.