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白细胞介素-8对冠心病患者经皮冠状动脉介入治疗后心脏事件和再狭窄的预后价值。

The prognostic value of IL-8 for cardiac events and restenosis in patients with coronary heart diseases after percutaneous coronary intervention.

作者信息

Qi Xiaoyong, Li Shuren, Li Junyong

机构信息

Cardiac Center of Hebei Provincial Pecople's Hospital, Shijiazhuang, China.

出版信息

Jpn Heart J. 2003 Sep;44(5):623-32. doi: 10.1536/jhj.44.623.

Abstract

The objective of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for adverse cardiac events and restenosis in patients with percutaneous coronary intervention (PCI). The pre- and post-procedural peak plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, while adverse cardiae events and restenosis within one year follow-up were observed in 134 consecutive patients who underwent PCI. Angiography revealed that 23.88% (32/134) of the patients had adverse cardiac events and 29.41% (35/119) of the patients had restenosis. Preprocedural levels of IL-8 and CRP and post-procedural peak levels of IL-8 in patients with adverse cardiac events were higher than those without adverse cardiac events (all P < 0.05). The incidence of adverse cardiac events increased from 6.67% in the bottom tertile to 31.82% in the top tertile of IL-8 levels (P = 0.001): a similar trend was observed for restenosis from 10% in low tertile to 51.28% in high tertile of IL-8 levels to 51.8% (P = 0.012). The preprocedural levels of IL-8 (RR = 5.539, CI = 1.720-17.887, P = 0.001) and CRP (RR = 2.031, CI = 1.132-2.049, P = 0.003) were the only independent predictors of adverse cardiac events. The post-procedure peak level of IL-8 (RR = 3.766, CI = 2.990-5.904, P = 0.002) and stent length (RR = 1.468, CI = 1.161-2.022. P = 0.021) were the independent predictors of restenosis. The results demonstrate that the release of IL-8 after PCI is a powerful prognostic factor for cardiac events and restenosis. The higher the peak level of post-procedure IL-8, the lower the event-free survival observed.

摘要

本研究的目的是探讨血浆白细胞介素-8(IL-8)对经皮冠状动脉介入治疗(PCI)患者不良心脏事件和再狭窄的预后价值。采用免疫分析法检测PCI术前和术后血浆IL-8和血清C反应蛋白(CRP)的峰值水平,同时观察134例连续接受PCI治疗患者在1年随访期内的不良心脏事件和再狭窄情况。血管造影显示,23.88%(32/134)的患者发生不良心脏事件,29.41%(35/119)的患者发生再狭窄。发生不良心脏事件患者的术前IL-8和CRP水平以及术后IL-8峰值水平高于未发生不良心脏事件的患者(均P<0.05)。不良心脏事件的发生率从IL-8水平最低三分位数的6.67%增至最高三分位数的31.82%(P=0.001);再狭窄也呈现类似趋势,从IL-8水平低三分位数的10%增至高三分位数的51.28%(P=0.012)。术前IL-8水平(RR=5.539,CI=1.720~17.887,P=0.001)和CRP水平(RR=2.031,CI=1.132~2.049,P=0.003)是不良心脏事件的唯一独立预测因素。术后IL-8峰值水平(RR=3.766,CI=2.990~5.904,P=0.002)和支架长度(RR=1.468,CI=1.161~2.022,P=0.021)是再狭窄的独立预测因素。结果表明,PCI术后IL-8的释放是心脏事件和再狭窄的有力预后因素。术后IL-8峰值水平越高,无事件生存率越低。

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