摘要
目的:探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后慢血流发生风险与梗死相关动脉管病变局部白细胞介素-6(IL-6)水平的关系。方法:共纳入STEMI行急诊PCI的患者56例,其中男性34例,女性22例,平均年龄(63.5±10.3)岁。PCI术前应用6F Diver CE抽吸导管在导丝支持下,于冠状动脉病变的远端局部取样,采用酶联免疫吸附法测定IL-6水平。结果:共计21例(37.5%)患者发生慢血流。多因素Logistic回归分析表明糖尿病(OR=0.124,95%CI:0.019-0.804,P=0.029)、血栓负荷评分(OR=0.080,95%CI:0.007-0.909,P=0.042)、局部IL-6(OR=0.623,95%CI:0.441-0.881,P=0.007)是慢血流发生的独立危险因素。ROC曲线表明局部IL-6(ROC面积0.824,OR=1.704,95%CI:1.274-2.281,P=0.001;理想阈值:≥11.3pg/ml)对慢血流的发生具有重要预测价值(敏感性为73%,特异性为71%)。结论 :梗死相关动脉病变局部IL-6水平升高与STEMI患者行急诊PCI术后慢血流的发生密切相关。
Objective： We aimed to investigate the association between local interleukin-6 （IL-6） levels at the infarct-related artery and the risk of slow flow after PCI in ST segment elevation myocardial infarction （STEMI） patients treated by successful primary PCI. Methods： 56 eligible STEMI patients （34 male/22 female, mean age： 63.5±10.3 years）, undergoing successfully primary PCI, were included in the current study. Blood samples were obtained from the extraction catheter placed distal to the lesion before PCI. Plasma IL-6 levels were determined by immunoassay method. Results： Slow flow was observed in 21 patients （37.5%）. Using multiple logistic regression analysis, local IL-6 levels （OR=0.623, 95%CI 0.441-0.881, P=0.007） were found to be a significant risk factor of slow flow together with diabetes mellitus （OR=0.124, 95%CI 0.019-0.804, P=0.029） and thrombus score （OR=0.080, 95%CI 0.007-0.909, P=0.042）. Receiver operating characteristic （ROC） curve analysis revealed that local IL-6 （ROC area 0.824, OR=1.704, 95%CI 1.274-2.281, P=0.001 and optimal threshold≥11.3 pg/ml） had a predictive value of slow flow with sensitivity of 73% and specificity of 71%. Conclusion： Our study indicated that inflammatory response as presented by local IL-6 levels was associated with slow flow in patients with STEMI after successfully primary PCI.
出处
《中国循环杂志》
CSCD
北大核心
2014年第3期185-188,共4页
Chinese Circulation Journal
基金
烟台市科技发展计划(批准编号:2013WS221)
关键词
白细胞介素-6
慢血流
炎症反应
急性心肌梗塞
Interleukin-6
Slow flow
Inflammation reaction
Acute myocardial infarction
