摘要
目的探讨影响急性ST段抬高心肌梗死（STEMI）患者住院期间并发泵衰竭的因素。方法根据急性心肌梗死泵衰竭Killip临床分级标准将首次发生且发病6h内入院的263例（男203例，女60例，年龄20-90岁）。急性STEMI患者分为心功能异常组和心功能正常组，记录患者临床资料，采用酶联免疫吸附法（ELISA）测定血清白介素6（IL-6）等炎性标记物水平。结果住院期间并发泵衰竭的STEMI患者年龄（P〈0．001）、入院心率（P=0．003）、女性比例（P=0．013）、合并糖尿病史（P=0．023）以及IL-6（P〈0．001）和可溶性白细胞分化抗原40配体（P=0．01）水平均显著高于心功能正常组。Spearman＇s相关分析显示IL-6与肌酸激酶、肌钙蛋白Ⅰ峰值呈显著正相关（均P〈0．05）。多因素Logistic回归分析得出年龄、入院心率和IL-6是影响急性STEMI住院期间并发泵衰竭的独立因素。结论IL-6水平与急性STEMI住院期间并发泵衰竭独立相关，提示IL-6可提供独立于传统危险因素的预后信息辅助急性STEMI的危险分层。
Objective To investigate the factors influencing in-hospital heart failure in patients with acute ST segment elevation myocardial infarction （STEMI）. Methods A tolal of 263 patients with acute STEMI [203 men and 60 women, mean age （61± 12） years] admitted to our institute within 6 h of symptom onset were enrolled in the study and divided into two groups according to in-hospital cardiac function Killip grade. Clinical data were collected and serum levels of interleukin-6（IL-6）, along with a number of other established biomarkers, were measured by enzyme-linked immunosorbent assay （ELISA）. Results Compared with control（normal heart function）, patients with heart failure were associated with a higher proportion of female and diabetic patients. Age, heart rate, IL-6 and soluble CD40 ligand were significantly higher in patients with heart failure than in control group. Spearman＇s correlation analysis showed that serum levels of IL-6 significantly and positively correlated with peak levels of creatine kinase and troponin I. Logistic regression analysis revealed that age, heart rate and IL-6 were independently associated with the incidence of in-hospital heart failure in patients with STEMI. Conclusion Elevated circulating level of IL-6 can provide additional predictive value over that provided by conventional risk factors to help risk stratification in patients with STEMI.
出处
《中华老年多器官疾病杂志》
2008年第1期33-35,39,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
