中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
Chinese Journal of Clinicians (Electronic Edition)
2015年
17期
3184-3187
,共4页
屈会娟%朱嘉俊%李晓梅%杨毅宁
屈會娟%硃嘉俊%李曉梅%楊毅寧
굴회연%주가준%리효매%양의저
白细胞介素6%主动脉夹层%死亡率
白細胞介素6%主動脈夾層%死亡率
백세포개소6%주동맥협층%사망솔
Interleukin-6%Aneurysm,dissecting%Mortality
目的:探讨白细胞介素-6(IL-6)对急性主动脉夹层患者的预后的预测价值。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月至2014年2月完全符合诊断标准的主动脉夹层患者87例,用酶联免疫吸附试验(ELISA)检测入院时血浆IL-6。以死亡作为随访终点,随访1年。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[(17.92±4.61)pg/ml vs.(12.59±2.53)pg/ml,P<0.001],且具有统计学意义。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0.862,95%置信区间=0.81~0.92,P<0.001),最佳临床分界点为18.36 pg/ml,敏感度为87.4%,特异度为70.8%。根据IL-6判断夹层患者死亡的最佳临床分界点(18.36 pg/ml),将患者分为IL-6降低组和IL-6升高组。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)=3.68(1.16~5.42),P<0.001;IL -6连续变量:HR(95%CI)=1.33(1.14~1.61), P=0.016],IL-6升高组和IL-6降低组的死亡率具有明显统计学差异(79.1%vs.24.5%,P<0.001)。结论 IL-6对急性主动脉夹层患者预后具有一定预测价值,并且能够识别高危患者。
目的:探討白細胞介素-6(IL-6)對急性主動脈夾層患者的預後的預測價值。方法連續入選新疆醫科大學第一附屬醫院心髒中心,2012年1月至2014年2月完全符閤診斷標準的主動脈夾層患者87例,用酶聯免疫吸附試驗(ELISA)檢測入院時血漿IL-6。以死亡作為隨訪終點,隨訪1年。採用ROC麯線和Cox生存迴歸分析IL-6對急性主動脈夾層患者死亡的預測價值。結果死亡組患者入院時IL-6高于存活組患者[(17.92±4.61)pg/ml vs.(12.59±2.53)pg/ml,P<0.001],且具有統計學意義。ROC麯線分析提示,IL-6對急性主動脈夾層患者死亡具有預測價值(麯線下麵積為0.862,95%置信區間=0.81~0.92,P<0.001),最佳臨床分界點為18.36 pg/ml,敏感度為87.4%,特異度為70.8%。根據IL-6判斷夾層患者死亡的最佳臨床分界點(18.36 pg/ml),將患者分為IL-6降低組和IL-6升高組。Cox生存迴歸分析顯示,IL-6和急性主動脈夾層患者死亡密切相關[IL-6分組:HR(95%CI)=3.68(1.16~5.42),P<0.001;IL -6連續變量:HR(95%CI)=1.33(1.14~1.61), P=0.016],IL-6升高組和IL-6降低組的死亡率具有明顯統計學差異(79.1%vs.24.5%,P<0.001)。結論 IL-6對急性主動脈夾層患者預後具有一定預測價值,併且能夠識彆高危患者。
목적:탐토백세포개소-6(IL-6)대급성주동맥협층환자적예후적예측개치。방법련속입선신강의과대학제일부속의원심장중심,2012년1월지2014년2월완전부합진단표준적주동맥협층환자87례,용매련면역흡부시험(ELISA)검측입원시혈장IL-6。이사망작위수방종점,수방1년。채용ROC곡선화Cox생존회귀분석IL-6대급성주동맥협층환자사망적예측개치。결과사망조환자입원시IL-6고우존활조환자[(17.92±4.61)pg/ml vs.(12.59±2.53)pg/ml,P<0.001],차구유통계학의의。ROC곡선분석제시,IL-6대급성주동맥협층환자사망구유예측개치(곡선하면적위0.862,95%치신구간=0.81~0.92,P<0.001),최가림상분계점위18.36 pg/ml,민감도위87.4%,특이도위70.8%。근거IL-6판단협층환자사망적최가림상분계점(18.36 pg/ml),장환자분위IL-6강저조화IL-6승고조。Cox생존회귀분석현시,IL-6화급성주동맥협층환자사망밀절상관[IL-6분조:HR(95%CI)=3.68(1.16~5.42),P<0.001;IL -6련속변량:HR(95%CI)=1.33(1.14~1.61), P=0.016],IL-6승고조화IL-6강저조적사망솔구유명현통계학차이(79.1%vs.24.5%,P<0.001)。결론 IL-6대급성주동맥협층환자예후구유일정예측개치,병차능구식별고위환자。
ObjectiveTo investigate the predictive value of interleukin-6 (IL-6) for mortality in patients with acute aortic dissection.Methods 87 patients diagnosed acute aortic dissection were consecutively enrolled in the study between January, 2012 and, February, 2014. Interleukin-6was detected by enzyme linked immunosorbent assay (ELISA). The primary endpoint was all-cause death, following up one year. Receiver operating characteristic (ROC) curve and Cox hazard ratio regression were used to analyse the predictive value of IL-6 for mortality in patients with acute aortic dissection. ResultsThe level of IL-6 of patients in the dead group was higher than that in the survival group with significant difference, (17.92±4.61)pg/ml vs. (12.59±2.53)pg/ml,P<0.001. ROC curve showed IL-6 could predict the mortality of patients with acute AD, a cut-off value was 18.36 pg/ml with sensitivity=87.4% and specificity=70.8%. The patients were divided into two groups: the high IL-6 group and the low IL-6 group. Cox analysis showed that IL-6 was associated with acute aortic dissection mortality (categorical data: HR (95%CI)= 4.26 (2.41-6.34),P<0.001; continuous data:HR (95%CI)=1.33 (1.14 to 1.61),P=0.016. Kaplan-Meier analysis showed that the survival rate was different between the high and low IL-6 group (P<0.001).ConclusionIL-6 was a death predictor of patients with acute aortic dissection and could identify high-risk aortic dissection patients.