维持性血液透析患者血清IL-6的表达水平与心功能指标及死亡率的关系

Correlation between serum IL-6 expression level and cardiac function index and mortality in maintenance hemodialysis patients

目的探讨血清白细胞介素-6(IL-6)的水平与维持性血液透析(MHD)患者心功能相关指标及死亡率的关系。方法选取2016年5月至2020年4月在该院血液净化中心进行MHD的210例患者为研究对象,根据IL-6的表达水平分为正常组(≤20 pg/mL)和高表达组(>20 pg/mL)。收集两组临床资料,记录1年内患者心血管事件发生率及死亡率。结果两组白蛋白、血红蛋白、C-反应蛋白及左心室收缩末期内径、左心室舒张末期内径、左心室射血分数、左室短轴缩短分数,以及1年内心血管事件发生率和死亡率比较,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,IL-6预测MHD患者1年内发生心血管事件的ROC曲线下面积(AUC)为0.791(95%CI:0.706~0.877),其最佳截断值为19.9 pg/mL,灵敏度和特异度分别为67.6%、83.2%。结论血清IL-6表达水平与MHD患者心功能不全、心血管事件发生率和预后相关。

Objective To investigate the relationship between serum interleukin-6(IL-6)level and cardiac function and mortality in maintenance hemodialysis(MHD)patients.Methods A total of 210 patients undergoing MHD in the blood purification center of this hospital from May 2016 to April 2020 were selected as the study objects,and were divided into normal group(≤20 pg/mL)and high expression group(>20 pg/mL)according to the expression level of IL-6.Clinical data of the two groups were collected,and the incidence of cardiovascular events and mortality of patients within 1 year were recorded.Results There were statistically significant differences in albumin,hemoglobin,C-reactive protein,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,left ventricular ejection fraction,left ventricular short-axis shortening fraction,and the incidence of cardiovascular events and mortality within 1 year between the two groups(P<0.05).Receiver operating characteristic(ROC)curve analysis results showed that the area under ROC curve(AUC)of IL-6 in predicting cardiovascular events in MHD patients within 1 year was 0.791(95%CI:0.706-0.877),the optimal cutoff value was 19.9 pg/mL,and the sensitivity and specificity were 67.6%and 83.2%,respectively.Conclusion Serum IL-6 expression level is associated with cardiac insufficiency,incidence of cardiovascular events and prognosis in MHD patients.