入院即刻IL-6对不稳定型心绞痛患者左心室射血分数和主要不良心血管事件的预测价值

Predictive value of immediate IL-6 level of admission on left ventricular ejection fraction and major adverse cardiovascular events in patients with unstable angina pectoris

目的探讨入院即刻白细胞介素-6(IL-6)水平对不稳定型心绞痛(UAP)患者左心室射血分数(LVEF)和主要不良心血管事件的预测价值。方法选取收治的UAP患者240例,入院即刻测定血清IL-6水平,根据血清IL-6水平将所有UAP患者分为两组,IL-6阳性组(IL-6≥200pg/L,114例)和IL-6阴性组(IL-6<200pg/L,126例),并在入院治疗3d后测定两组患者的LVEF。患者出院后随访48个月,平均(47.5±2.3)个月,评价入院即刻IL-6水平与LVEF和主要不良心血管事件的关系。结果IL-6阳性组患者LVEF低于IL-6阴性组,差异有统计学意义(t=13.016,P<0.05)。UAP患者入院即刻血清IL-6水平与治疗后LVEF呈负相关(r=-0.383,P<0.05);与IL-6阳性组相比,IL-6阴性组患者主要不良心血管事件的发生率较低,差异均有统计学意义(P<0.05或0.01)。结论入院即刻IL-6水平可作为UAP患者LVEF和不良心血管事件的预测因子。

Objective To investigate the predictive value of immediate interleukin-6(IL-6) on left ventricular ejection fraction and adverse cardiovascular and cerebrovascular events in patients with unstable angina pectoris.Methods 240 cases of patients with unstable angina pectoris admitted to our hospital from January 2012 to December 2013 were selected and the serum IL-6 concentration was measured immediately after admission. All UAP patients were divided into two groups based on serum IL-6 concentration: IL-6 positive group(IL-6≥200pg/L,n=114)and IL-6 negative group. The left ventricular ejection fraction of each group were measured 3 days after admission.Patients were followed up for 47.5±2.3 months after discharge to obtain the prognosis. According to these data,the correlation between IL-6 content and left ventricular ejection fraction and adverse cardiovascular and cerebrovascular events was evaluated.Results The LVEF of IL-6 positive group was lower than that of IL-6 negative group(t= 13.016,P<0.05). The level of serum IL-6 was negatively correlated with LVEF in UAP patients immediately after admission(r=-0.383,P<0.05). Compared with IL-6 positive group,the incidence of adverse cardiovascular and cerebrovascular events in IL-6 negative group was lower,and the difference was statistically significant(all P<0.05).Conclusion The immediate IL-6 level of admission can be used as a predictor of left ventricular ejection fraction and adverse cardiovascular and cerebrovascular events in patients with unstable angina.