雌二醇/睾酮比值、白细胞介素6、降钙素原水平与慢性心衰的关系

Relationship among ratio of estradiol to testosterone,interleukin-6,procalcitonin and chronic heart failure

目的探讨雌二醇(E2)、睾酮(T)、雌二醇/睾酮比值(E2/T)、白细胞介素6(IL-6)、降钙素原(PCT)水平变化与慢性心力衰竭(心衰)的关系。方法选取慢性心衰患者100例(心衰组)及健康体检者100例(非心衰组)为研究对象。采用酶联免疫吸附试验法(ELISA)检测血清PCT、IL-6水平,化学发光法测定检测E2、T的含量,电化学发光法检测N末端脑钠肽前体(NT-proBNP)。探讨E2/T比值、PCT、IL-6与慢性心力衰竭的关系。采用Logistic回归分析分析各组性激素、IL-6及PCT与心衰的关系并进行统计学分析。结果心衰组与非心衰组比较,E2、T、E2/T差异有统计学意义(P<0.05)。心衰组IL-6、NT-proBNP显著高于非心衰组,差异有统计学意义(P<0.05)。单因素和多因素Logistic回归分析显示:①E2/T曲线下面积(0.762,95%CI:0.690~0.835,P<0.001);②IL-6曲线下面积(0.693,95%CI:0.615~0.771,P<0.001);③NT-proBNP曲线下面积(0.792,95%CI:0.731~0.854,P<0.001)。④NT-proBNP+E2/T曲线下面积(0.823,95%CI:0.767~0.879,P<0.001)。⑤NT-proBNP+IL-6曲线下面积(0.803,95%CI:0.743~0.863,P<0.001)。结论血清E2/T比值、IL-6、NT-proBNP是心衰患者的独立危险因素。

Objective To investigate the relationship among estradiol(E2),testosterone(T),ratio of estradiol to testosterone(E2/T),interleukin-6(IL-6)and procalcitonin(PCT)and chronic heart failure(CHF).Methods CHF patients(n=100,CHF group)and healthy controls(n=100,non-CHF group)were chosen as study objects.The levels of serum PCT and IL-6 were detected by using enzym-linked immunosorbent assay(ELISA),content of E2 and T were detected by using chemiluminescence assay,and level of N-terminal pro-brain natriuretic peptide(NT-proBNP)was detected by using electro-chemiluminescence assay.The relationship among E2/T,PCT,IL-6 and CHF was discussed.The relationship among sex hormone,IL-6,PCT and CHF was analyzed statistically by using Logistic regression analysis.Results The difference in E2,T and E2/T had statistical significance between 2 groups(P<0.05).The levels of IL-6 and NT-proBNP were significantly higher in CHF group than those in non-CHF group(P<0.05).The results of single-factor and multi-factor Logistic regression analysis showed that①area under ROC curve of E2/T was 0.762(95%CI:0.690~0.835,P<0.001),②area under ROC curve of IL-6 was 0.693(95%CI:0.615~0.771,P<0.001),③area under ROC curve of NT-proBNP was 0.792(0.792,95%CI:0.731~0.854,P<0.001),④area under ROC curve of NT-proBNP+E2/T was 0.823(95%CI:0.767~0.879,P<0.001),and⑤area under ROC curve of NT-proBNP+IL-6 was 0.803(95%CI:0.743~0.863,P<0.001).Conclusion The changes of serum E2/T,IL-6 and NT-proBNP are independent risk factors in CHF patients.