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C 反应蛋白和白细胞介素-6 在透析患者中的预后作用:系统评价和荟萃分析。

Prognostic role of C-reactive protein and interleukin-6 in dialysis patients: a systematic review and meta-analysis.

机构信息

Institutes for Advanced Interdisciplinary Research, East China Normal University, Shanghai, PR China.

出版信息

J Nephrol. 2013 Mar-Apr;26(2):243-53. doi: 10.5301/jn.5000169. Epub 2012 Jun 8.

Abstract

Inflammation may be associated with mortality in dialysis patients. This study aims to summarize the prognostic value of two common inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6) for dialysis outcome. A total of 109 CRP studies and 22 IL-6 studies were identified from PubMed and EMBASE after systematic searching and assessment. The combined hazard ratios (HRs) of CRP and IL-6 for mortality were analyzed. For all-cause mortality (ACM), both CRP and IL-6 could significantly predict the outcome, with the pooled HRs of 1.142 (95%CI: 1.118-1.166) and 1.152 (95%CI: 1.094-1.214) for CRP and IL-6, respectively. For cardiovascular disease mortality (CVDM), the pooled HR of CRP (1.182, 95%CI: 1.134-1.232) was close to that of IL-6 (1.181, 95%CI: 1.068-1.307). Therefore, elevated levels of CRP or IL-6 were significantly associated with higher ACM and higher CVDM in dialysis patients. The predictive value of the inflammatory biomarkers may be useful in clinical practice.

摘要

炎症可能与透析患者的死亡率有关。本研究旨在总结两种常见炎症标志物 C 反应蛋白 (CRP) 和白细胞介素 6 (IL-6) 对透析结果的预后价值。通过系统搜索和评估,从 PubMed 和 EMBASE 中确定了 109 项 CRP 研究和 22 项 IL-6 研究。分析了 CRP 和 IL-6 对死亡率的联合危险比 (HR)。对于全因死亡率 (ACM),CRP 和 IL-6 均可显著预测结局,CRP 和 IL-6 的合并 HR 分别为 1.142 (95%CI:1.118-1.166) 和 1.152 (95%CI:1.094-1.214)。对于心血管疾病死亡率 (CVDM),CRP 的合并 HR (1.182,95%CI:1.134-1.232) 接近 IL-6 的合并 HR (1.181,95%CI:1.068-1.307)。因此,CRP 或 IL-6 水平升高与透析患者 ACM 更高和更高的 CVDM 显著相关。炎症生物标志物的预测价值可能在临床实践中有用。

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