白细胞介素-6及C-反应蛋白与急性心肌梗死后心室重构的相关性研究

目的:评价血清白细胞介素6(IL6)和C反应蛋白(CRP)对心肌梗死后心室重构的预测价值。方法:测定64例首次急性心肌梗死患者发病72小时的IL6和CRP及第14天的超声心动图,根据IL6浓度将患者分成高IL6组和低IL6组,比较两组间心室重构各指标。结果:高IL6组CRP浓度、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)、左心室重构(LVRM)总的发生率明显升高,左心室射血分数(LVEF)降低,与低IL6组比较均有统计学差异(P<0.05)。两组室壁瘤发生率无统计学差异(P>0.05)。血清IL6与血清CRP、左心室舒张末容积、左心室收缩末容积、室壁瘤、心室重构均呈显著正相关,与左心室射血分数呈显著负相关。血清CRP与左心室收缩末容积、室壁瘤、心室重构呈显著正相关,与左心室射血分数呈显著负相关,但是与左心室舒张末容积无显著相关性。CRP进入Logistic回归方程。结论:心肌梗死后72小时高水平IL6和CRP与心肌梗死后心室重构呈正相关,血清高CRP浓度是预测心肌梗死急性期发生心室重构的独立预测因素。

Interleukin-6 and C-reactive Protein in Acute Myocardial Infarction:Association With Left Ventricular Remodeling

Objective:To assess the prognosis value of serum interleukin-6 (IL-6) and C-reactive protein (CRP) in post-acute myocardial infarction (AMI) left ventricular remodeling (LVRM).Methods:Sixty-four patients with first AMI within 12 hours after symptom onset were enrolled into this study.Serum IL-6 and CRP at 72 hours of onset and echocardiogram at 14 days of onset were measured. The patients were divided into two groups according to the level of IL-6:low IL-6 group ang high IL-6 group. The LVRM parameters of the two groups were compared. Results:The level of CRP,left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV) and the ratio of LVRM in high IL-6 group were significantly raised (P<0.05),whereas left ventricular ejection (LVEF) was significantly lower than that of the low IL-6 group (P<0.05). IL-6 was positively correlated with CRP,LVEDV,LVESV,ratio of cardiac aneurysm and LVRM (P<0.05). CRP had positive correlation with LVESV and cardiac aneurysm (P<0.05),negative correlation with LVEF (P<0.05),but no significant correlation with LVEDV (P>0.05). Only CRP entered as an independent variable in the logistic analysis with LVRM.Conclusion:The high levels of serum IL-6 and CRP at 72 h post-AMI are strongly positively correlated with LVRM. High CRP level is an independent predictor of left ventricular remodeling in the early phase of AMI.