D-D、IL-6对不同射血分数心衰患者的诊断价值

The clinical value of D-D and IL-6 in the diagnosis of heart failure patients with different ejection fraction

目的探讨D-D(D-二聚体)、IL-6(白细胞介素-6)与不同射血分数心力衰竭的差异及相关意义。方法选取内蒙古医科大学附属医院心血管内科于2015年12月至2017年3月收治的充血性心力衰竭患者89例,及33例经门诊检查证实无器质性心脏病的健康人作为对照组。将心衰组分为射血分数减低心力组(HFr EF)、射血分数中间组(HFmr EF)和射血分数保留组(HFpEF)。入院后完善BNP、生化、超声等相关检查,并检测D-D、IL-6表达水平。结果(1)与对照组相比,三组心力衰竭患者的IL-6、D-D水平升高,组间比较具有统计学意义(P<0.01);(2)心衰组患者IL-6、D-D、与NT-Pro BNP呈正相关(P<0.01),与LVEF呈负相关(P<0.01);(3)IL-6、D-D诊断心力衰竭的受试者工作特征曲线(ROC曲线)下面积分别为0.955、0.895差异有统计学意义(P<0.01);(4)因素回归分析显示:不同心力衰竭的危险因素包括IL-6、D-D。结论D-D、IL-6是心衰的危险因素,对于心衰的诊断有参考价值。

Objective To discuss the difference and correlation significance between D-D、IL-6 in heart failure(HF)patients with different ejection fraction.Methods Select 89 patients with congestive heart failure admitted by the Department of Cardiovascular Medicine of the Affiliated Hospital of Inner Mongolia Medical University from December 2015 to March 2017,and 33 healthy people who were confirmed to have no organic heart disease by outpatient examination as the control group.The heart failure group was divided into the ejection fraction reduction cardiac force group(HFr EF),the ejection fraction intermediate group(HFmr EF)and the ejection fraction retention group(HFpEF).Complete BNP,biochemistry,ultrasound and other related examinations after admission,and detect the expression level of D-D,IL-6.Results(1)Compared with the control group,the levels of IL-6 and D-dimer in patients with heart failure in the three groups were significantly higher(P0.01)IL-6,D-D in patients with heart failure were positively correlated(P0.01)with NT-Pro BNP,and negatively correlated with LVEF and LVEF(P0.01).(2)IL-6,D-D in patients with heart failure were positively correlated with NT-Pro BNP(P 0.01),and negatively correlated with LVEF and LVEF(P 0.01).(3)The area under the working characteristic curve(ROC curve)of subjects with IL-6 and D-D diagnosis of heart failure was 0.955 and 0.895 respectively,with statistically significant difference(P0.01).(4)Factor regression analysis shows that the risk factors of different heart failure include IL-6and D-D,which are risk factors of heart failure.Conclusions D-D and IL-6 are risk factors of heart failure,which have reference value for the diagnosis of heart failure.