IL-6和黏附分子对急性ST段抬高心肌梗死患者住院期间死亡的预测作用

目的检测急性ST段抬高心肌梗死(STEMI)患者血清白细胞介素-6(IL-6)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性P选择素(sP-selectin)水平的变化,探讨其在STEMI患者住院期间死亡的预测作用。方法用ELISA法检测263例初发急性ST段抬高心肌梗死患者血清IL-6、sICAM-1、sVCAM-1和sP-selectin水平,统计分析炎症因子情况与住院死亡的相关性。结果共18例(6.84%)STEMI患者在住院期间死亡;与存活组相比,死亡组平均年龄明显偏高(P<0.001)、女性比例高(P<0.048)、平均体质量指数低(P<0.034)、高血压和2型糖尿病病史多见(P<0.016和P<0.043)。死亡组血清IL-6水平显著高于存活组(P<0.001);死亡组血清sICAM-1、sVCAM-1和sP-selectin水平与存活组差异无统计学意义;用ROC曲线分析血清IL-6水平对住院死亡率的预测价值,曲线下面积为0.787(95%CI:0.678～0.897,P<0.001),血清IL-6水平预测死亡的界值为7.082ng/L;多元Logistic回归分析示年龄≥75岁(P=0.049)和血清高IL-6水平(P=0.019)与住院死亡独立相关。结论STEMI患者住院期间死亡与年龄和血清IL-6水平升高相关,高龄和升高的血清IL-6水平对STEMI患者住院期间死亡均有独立预测价值。

Prognostic Value of IL-6 and Adhesion Molecule on In-hospital Mortality in Patients with ST-segment Elevation Acute Myocardial Infarction

Objective The aim of the present study is to assess the prognostic value of serum interleukin-6(IL-6),soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1) and soluble P-selectin(sP-selectin) on in-hospital mortality in patients with ST-segment elevation acute myocardial infarction(STEMI).Methods The single-centre study enrolled 263 consecutive patients with STEMI.Data on patients' histories,comorbidity,presenting features and reperfusion treatments were colle...