血清白细胞介素 6（IL-6）与脑出血后功能结局的关系。

Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage.

机构信息

Department of Neurology (A.C.L., L.R.K., K.N.V., L.H.S., G.J.F., K.N.S.), Yale University School of Medicine, New Haven, CT.

Divisions of Stroke, Cerebrovascular and Critical Care Neurology, Brigham and Women's Hospital, Boston, MA (M.B.B.).

出版信息

Stroke. 2021 May;52(5):1733-1740. doi: 10.1161/STROKEAHA.120.032888. Epub 2021 Mar 8.

DOI:10.1161/STROKEAHA.120.032888

PMID:33682454

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8085132/

Abstract

BACKGROUND AND OBJECTIVES

IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH).

METHODS

We performed an exploratory analysis of the recombinant activated FAST trial (Factor VII for Acute ICH). Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin Scale. In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema volumes.

RESULTS

Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (modified Rankin Scale, 4-6; per additional 1 ng/L, odds ratio, 1.30 [95% CI, 1.04-1.63]; =0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex, and ICH location, and this association was modified by location (multivariable interaction, =0.002), with a stronger association seen in lobar (β, 12.51 [95% CI, 6.47-18.55], <0.001) versus nonlobar (β 5.32 [95% CI, 3.36-7.28], <0.001) location. IL-6 was associated with perihematomal edema volume after adjustment for age, sex, ICH volume, and ICH location (β 1.22 [95% CI, 0.15-2.29], =0.03). Treatment group was not associated with IL-6 levels or outcome.

CONCLUSIONS

In the FAST trial population, higher admission IL-6 levels were associated with worse 90-day functional outcome and larger ICH and perihematomal edema volumes.

摘要

背景与目的

白细胞介素 6（IL-6）是一种促炎细胞因子，也是急性脑损伤的既定生物标志物。我们试图确定入院时的 IL-6 水平是否与自发性脑出血（ICH）后的严重程度和功能结局相关。

方法

我们对重组激活因子 FAST 试验（Factor VII for Acute ICH）进行了探索性分析。纳入入院时血清 IL-6 水平可检测的患者。回归分析用于评估 IL-6 与 90 天改良 Rankin 量表之间的关系。在次要分析中，我们使用线性回归评估 IL-6 与基线 ICH 和血肿周围水肿体积之间的关系。

结果

在纳入的 841 名患者中，我们纳入了 552 名（66%）入院时 IL-6 水平可检测的患者（平均年龄 64 [13]岁，女性 203 名[37%]）。IL-6 与不良结局相关（改良 Rankin 量表，4-6 分；每增加 1ng/L，比值比 1.30 [95%置信区间，1.04-1.63]；=0.02），校正 ICH 后已知结局预测因子和治疗组后。IL-6 与 ICH 体积相关，校正年龄、性别和 ICH 部位后，且该相关性与部位有关（多变量交互作用，=0.002），在皮质（β，12.51 [95%置信区间，6.47-18.55]，<0.001）与非皮质（β，5.32 [95%置信区间，3.36-7.28]，<0.001）部位之间的相关性更强。IL-6 与血肿周围水肿体积相关，校正年龄、性别、ICH 体积和 ICH 部位后（β 1.22 [95%置信区间，0.15-2.29]，=0.03）。治疗组与 IL-6 水平或结局无关。