hs-CRP联合IL-6对2型糖尿病患者冠心病的预测价值

Predictive value of hs CRP combined with IL-6 on coronary heart disease in patients with type 2 diabetes

目的探讨高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6)对2型糖尿病(T2DM)患者冠心病(CHD)的预测价值。方法选取平煤神马医疗集团总医院2020年2月至2023年2月期间胸痛住院的T2DM患者153例,合并CHD者64例为观察组,无CHD者89例为对照组,收集比较两组临床资料及实验室参数,分析IL-6和hs-CRP与Gensini评分的相关性,T2DM患者CHD的危险因素,以及IL-6和hs-CRP对T2DM患者CHD的预测价值。结果观察组年龄,T2DM病程,高血压比率,收缩压,及血清IL-6、hs-CRP、Hcy、UA和FFA水平均高于对照组,T2DM病程较长,高血压,以及较高的年龄、UA、FFA、IL-6、hs-CRP和Hcy是T2DM患者发生CHD的独立危险因素,调整混杂因素后IL-6和hs-CRP仍具有显著性。hs-CRP与IL-6正相关(r=0.646,P<0.001),hs-CRP(r=0.278,P=0.001)和IL-6(r=0.374,P<0.001)与Gensini评分正相关。ROC临界值hs-CRP为2.00 mg/L,IL-6为26.16 pg/mL,与单独检测hs-CRP(Z=2.06,P=0.045)或IL-6(Z=2.03,P=0.035)相比,两者联合检测具有更高的预测效能。结论T2DM病程较长,高血压,以及较高的年龄、UA、FFA、IL-6、hs-CRP和Hcy是T2DM患者发生CHD的独立危险因素,IL-6和hs-CRP在预测T2DM患者发生CHD方面具有较高价值,hs-CRP和Hcy联合检测可起到更好的预测作用。

Objective To explore the predictive value of high-sensitivity C-reactive protein(hs CRP)and Interleukin 6(IL-6)in coronary heart disease(CHD)in patients with type 2 diabetes(T2DM).Methods Totally 153 T2DM pa⁃tients with chest pain admitted between February 2020 and February 2023 were selected,with 64 patients with combined CHD as the observation group and 89 patients without CHD as the control group.Clinical data and laboratory parameters were collected and compared between the two groups.The correlation between IL-6 and hs CRP and Gensini score was analyzed,as well as the risk factors for CHD in T2DM patients,and the predictive value of IL-6 and hs CRP for CHD in T2DM patients.Results The age,course of T2DM,hypertension rate,systolic blood pressure,and serum IL-6,hs CRP,Hcy,UA,and FFA levels in the observation group were all higher than those in the control group.T2DM had a lon⁃ger course,hypertension,and higher age,UA,FFA,IL-6,hs CRP,and Hcy were independent risk factors for CHD in T2DM patients.After adjusting for confounding factors,IL-6 and hs CRP still had high significance.The levels of hs CRP and IL-6 were positively correlated(r=0.646,P<0.001),while hs CRP(r=0.278,P=0.001)and IL-6(r=0.374,P<0.001)were positively correlated with the Gensini score.The ROC threshold values of hs CRP and IL-6 are 2.00 mg/L and 26.16 pg/mL,respectively.Compared with the detection of hs CRP alone(Z=2.06,P=0.045)or IL-6 alone(Z=2.03,P=0.035),the combined detection of the two has higher predictive power.Conclusion The longer course of T2DM,hypertension,as well as higher age,UA,FFA,IL-6,hs CRP,and Hcy are independent risk factors for CHD in T2DM patients.IL-6 and hs CRP have high value in predicting whether T2DM patients will develop CHD,and the combined detection of hs CRP and Hcy can play a better predictive role.