CAJ | 학술논문

目的：探讨白细胞介素-6（ IL-6）与急性A型主动脉夹层患者的长期预后关系。方法连续入选新疆医科大学第一附属医院心脏中心2012年1月－2014年2月完全符合诊断标准的A型主动脉夹层患者36例，采用酶联免疫吸附法（ELISA）双抗体夹心法检测入院时血浆IL-6水平。以随访1年死亡作为随访终点。采用ROC曲线和Cox生存回归分析IL-6对急性主动脉夹层患者死亡的预测价值。结果死亡组患者入院时IL-6高于存活组患者（18.13±4.2 vs 13.24±2.8，P=0.001），具有统计学意义。ROC曲线分析提示，IL-6对急性主动脉夹层患者死亡具有预测价值（曲线下面积为0.822,95%置信区间=0.80~0.92，P<0.005），最佳临床分界点为19.09pg/mL，敏感度为84.9%，特异度为73.7%。根据IL-6判断夹层患者死亡的最佳临床分界点（19.09pg/mL），将患者分为IL-6较低组和IL-6较高组。Cox生存回归分析显示，IL-6和急性主动脉夹层患者死亡密切相关[IL-6分组：HR（95%CI）=4.45（2.17~7.46），P<0.001；IL-6连续变量：HR（95%CI）=1.42（1.29~1.68），P=0.032]。IL-6较高组和IL-6较低组的死亡率具有明显统计学差异（78.5%vs 23.6%，P<0.001）。结论 IL-6的表达水平与急性A型主动脉夹层患者的预后具有明显相关性，IL-6>19.09 pg/mL对急性A型主动脉夹层患者远期死亡事件具有预测价值。
목적：탐토백세포개소-6（ IL-6）여급성A형주동맥협층환자적장기예후관계。방법련속입선신강의과대학제일부속의원심장중심2012년1월－2014년2월완전부합진단표준적A형주동맥협층환자36례，채용매련면역흡부법（ELISA）쌍항체협심법검측입원시혈장IL-6수평。이수방1년사망작위수방종점。채용ROC곡선화Cox생존회귀분석IL-6대급성주동맥협층환자사망적예측개치。결과사망조환자입원시IL-6고우존활조환자（18.13±4.2 vs 13.24±2.8，P=0.001），구유통계학의의。ROC곡선분석제시，IL-6대급성주동맥협층환자사망구유예측개치（곡선하면적위0.822,95%치신구간=0.80~0.92，P<0.005），최가림상분계점위19.09pg/mL，민감도위84.9%，특이도위73.7%。근거IL-6판단협층환자사망적최가림상분계점（19.09pg/mL），장환자분위IL-6교저조화IL-6교고조。Cox생존회귀분석현시，IL-6화급성주동맥협층환자사망밀절상관[IL-6분조：HR（95%CI）=4.45（2.17~7.46），P<0.001；IL-6련속변량：HR（95%CI）=1.42（1.29~1.68），P=0.032]。IL-6교고조화IL-6교저조적사망솔구유명현통계학차이（78.5%vs 23.6%，P<0.001）。결론 IL-6적표체수평여급성A형주동맥협층환자적예후구유명현상관성，IL-6>19.09 pg/mL대급성A형주동맥협층환자원기사망사건구유예측개치。
Objective To discuss the correlation between interleukin-6 (IL-6) and the long-term prognosis of the patients with acute type A aortic dissection. Methods 36 patients with acute type A aortic dissection in the heart center of the 1st Affiliated Hospital to Xinji-ang Medical University were enrolled in the study;ELISA was applied in detecting the level of IL-6 of the patients at admission;death 1 year after follow-up was set as the end of the follow-up;receiver operating characteristic (ROC) curve and Cox hazard ratio regression were applied in analyzing the predicative value of IL-6 for the death of the patients with acute aortic dissection. Results The level of IL-6 of the patients in death group at admission was higher than that of the patients in survival group (18.13 ± 4.2 vs 13.24 ± 2.8, P=0.001), the difference was of statistical significance;ROC curve analysis showed that IL-6 was of predicative value for the death of the patients with acute type A aortic dissection (the area under ROC curve was 0.822, 95%of the confidence intervals=0.80-0.92, P<0.05), and the cut-off value was 19.09 pg/mL with sensitivity=84.9%and specificity=73.7%, according to which, the patients were divided in-to 2 groups:high IL-6 group and low IL-6 group;Cox regression analysis showed that IL-6 was closely correlated to the death of the pa-tients with acute aortic dissection (categorical data: HR (95% CI) = 4.45 (2.17-7.46), P<0.001; continuous variables: HR (95% CI)=1.42 (1.29- 1.68), P=0.032); the death rates in high IL-6 group and low IL-6 group were of obvious statistical difference (78.5% vs 23.6%, P<0.001). Conclusions There exists an obvious correlation between IL-6 and the prognosis of the patients with acute type A aor-tic dissection, and IL-6>19.09pg/mL is of predicative value for the late death of the patients with acute type A aortic dissection.