血清s IL-6R、IL-18水平与急性心肌梗死患者PCI治疗预后的相关性

Correlation between serum sIL-6R,IL-18 levels and prognosis of patients with acute myocardial infarction after PCI

目的分析血清可溶性白细胞介素6 (sIL-6R)、白细胞介素18 (IL-18)水平与急性心肌梗死患者经皮冠状动脉介入术(PCI)治疗预后的关系。方法回顾性分析2018年6月至2019年12月三门峡市中心医院行PCI治疗后发生不良心血管事件(MACE)的41例急性心肌梗死(AMI)患者资料,将其纳入预后不良组,采集医院同期行PCI治疗后未发生MACE的41例AMI患者资料,纳入预后良好组。统计两组患者治疗前血清sIL-6R、IL-18检验数据及基线资料,观察血清sIL-6R、IL-18水平与AMI患者PCI治疗预后的关系,及其对预后不良的预测价值。结果预后不良组AMI患者治疗前血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白-I(cTnI)、白细胞介素-6(IL-6)、sIL-6R、IL-18水平均高于预后良好组(P<0.05);组间其他资料比较,差异无统计学意义(P>0.05);经相关性分析发现,AMI患者的血清sIL-6R、IL-18水平呈正相关(r>0,P<0.05);经Logistic回归分析结果显示,血清sIL-6R、IL-18高表达可能与AMI患者PCI治疗预后不良有关,可作为AMI患者PCI治疗预后不良的风险因子(O^R>1,P<0.05);绘制ROC曲线,结果显示,治疗前血清sIL-6R、IL-18水平预测AMI患者PCI治疗预后不良风险的曲线下面积(AUC)均>0.80,预测价值较为理想,且以联合预测价值最高。结论 AMI患者PCI治疗预后不良可能与治疗前血清sIL-6R、IL-18高表达有关,可考虑PCI治疗前测定AMI患者的血清sIL-6R、IL-18,预测预后不良风险。

【Objective】 To analyze the relationship between serum soluble interleukin-6(s IL-6 R) and interleukin-18(IL-18) levels and prognosis of patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).【Methods】 The data of 41 AMI patients with adverse cardiovascular events(MACE) after PCI in Sanmenxia Central Hospital from June 2018 to December 2019 were retrospectively analyzed and included into the poor prognosis group,and the data of 41 AMI patients without MACE after PCI at the same period in the hospital were collected and included into the good prognosis group.Before treatment,serum s IL-6 R,IL-18 test data and baseline data of the two groups were counted,the relationship between the serum s IL-6 R and IL-18 levels and the prognosis of AMI patients after PCI,and their predictive value for poor prognosis were observed.【Results】 The levels of serum creatine kinase isoenzyme(CK-MB),cardiac troponin-I(cTnI),interleukin-6(IL-6),sIL-6 R and IL-18 before treatment in AMI patients in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05);there was no statistically significant difference in the comparison of other data between the two groups(P>0.05);the correlation analysis showed that serum sIL-6 R and IL-18 levels were positively correlated in patients with AMI(r>0,P<0.05);the results of logistic regression analysis showed that the high expression of serum sIL-6 R and IL-18 might be related to the poor prognosis of AMI patients after PCI,which could be used as a risk factor for poor prognosis of AMI patients after PCI(O^R>1,P<0.05);the ROC curve was drawn,and the results showed that the AUC of serum sIL-6 R and IL-18 levels in predicting the risk of poor prognosis in AMI patients before PCI treatment were all >0.80,the predictive value was ideal,and the joint prediction value was the highest.【Conclusion】 The poor prognosis of AMI patients after PCI may be related to the high expression of sIL-6 R and IL-18 before PCI,the serum sIL-6 R and IL-18 levels of patients with AMI can be measured before PCI to predict the risk of poor prognosis.