腹膜透析基线血清中IL-6表达水平与3年内心脑血管病并发症的相关性研究

党珊; 马文静; 陈惠霞; 尚瑞华; 王树龙

doi:10.16766/j.cnki.issn.1674-4152.003999

腹膜透析基线血清中IL-6表达水平与3年内心脑血管病并发症的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003999

1.
焦作煤业(集团)有限责任公司中央医院肾脏风湿免疫科，河南焦作 454150
2.
新乡医学院第一附属医院肾脏风湿免疫科，河南新乡 453199

基金项目:

河南省医学科技攻关计划项目 LHGJ20210529

详细信息

通讯作者:
王树龙，E-mail：602419229@qq.com

中图分类号: R459.5
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出版历程
- 收稿日期: 2024-12-11
- 网络出版日期: 2025-08-14

Correlation between baseline serum IL-6 levels and cardiovascular and cerebrovascular complications within 3 years in peritoneal dialysis patients

1.
Department of Renal Rheumatology and Immunology, Central Hospital of Jiaozuo Coal Group, Jiaozuo, Henan 454150, China

摘要

摘要: 目的探讨腹膜透析患者基线血清中IL-6水平以及IL-6是否可作为预测患者3年内发生心脑血管病并发症的一项生物学标志物。方法纳入焦作煤业(集团)有限责任公司中央医院和新乡医学院第一附属医院于2019年6月—2020年6月确诊的170例终末期肾脏病患者(腹膜透析组)和60例同期健康对照人群(对照组)作为研究对象。腹膜透析组随访36个月并根据随访情况分为非心脑血管并发症组(106例)和心脑血管并发症组(64例)。分析腹膜透析患者发生心脑血管并发症的危险因素，采用ROC曲线分析预测效能，分析IL-6表达水平与发生心脑血管并发症中位时间的关系。结果与对照组相比，IL-6在腹膜透析组中表达升高(P < 0.001)。与非心脑血管并发症组相比，超敏C反应蛋白、尿酸、TG、TC、LDL-c和IL-6在心脑血管并发症组中均显著升高(P < 0.05)。超敏C反应蛋白、LDL-c和IL-6是腹膜透析患者发生心脑血管并发症的独立影响因素。腹膜透析患者基线血清中IL-6表达水平预测心脑血管并发症发生的AUC为0.923，诊断灵敏度和特异度分别为93.25%和95.87%。IL-6高表达组和低表达组出现心脑血管并发症的中位时间分别为16个月和27个月，差异有统计学意义(HR=1.688，95% CI：1.082~2.293，P < 0.001)。结论 IL-6可作为预测腹膜透析患者出现心脑血管并发症的一项生物学标志物。
- 腹膜透析 /
- 心脑血管并发症 /
- 白细胞介素-6 /
- 预后
Abstract: Objective To investigate the serum baseline level of IL-6 in peritoneal dialysis patients and assess its potential as a biomarker for predicting the development of cardiovascular and cerebrovascular complications within 3 years. Methods A total of 170 patients with end-stage renal disease undergoing peritoneal dialysis and 60 healthy controls in Central Hospital of Jiaozuo Coal Group and the First Affiliated Hospital of Xinxiang Medical University between June 2019 and June 2020 were enrolled in the study. All patients with peritoneal dialysis were followed for 36 months. The patients were divided into the non-cardiovascular and cerebrovascular complications group (n=106) and the cardiovascular and cerebrovascular complications group (n=64). Risk factors for cardiovascular and cerebrovascular complications in peritoneal dialysis patients were analyzed, and the predictive efficacy of IL-6 was analyzed by ROC curve. The relationship between IL-6 expression levels and the median time to onset of cardiovascular and cerebrovascular complications was examined. Results The IL-6 expression level was significantly elevated in the peritoneal dialysis group compared to the control group (P < 0.001). In contrast with the non-cardiovascular and cerebrovascular complications group, the serum levels of hypersensitive C-reactive protein, uric acid, TG, TC, LDL-c, and IL-6 were significantly enhanced in the cardiovascular and cerebrovascular complications group (P < 0.05). The hypersensitive C-reactive protein, LDL-c, and IL-6 were identified as independent risk factors for cardiovascular and cerebrovascular complications in patients with peritoneal dialysis. The AUC for baseline serum IL-6 expression level in predicting cardiovascular and cerebrovascular complications in patients with peritoneal dialysis was 0.923, with a sensitivity of 93.25% and specificity of 95.87%. The median time to cardiovascular and cerebrovascular complications onset was shorter in the high IL-6 expression group (16 months) compared to the low IL-6 expression group (27 months, HR=1.688, 95% CI: 1.082-2.293, P < 0.001). Conclusion The serum IL-6 can serve as a valuable biomarker for predicting the cardiovascular and cerebrovascular complications in peritoneal dialysis patients.
- Peritoneal dialysis /
- Cardiovascular and cerebrovascular complications /
- IL-6 /
- Prognosis

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图 1 腹膜透析患者基线血清IL-6表达水平预测心脑血管并发症发生的ROC曲线

Figure 1. The ROC curve of baseline serum IL-6 expression level in predicting the incidence of cardiovascular and cerebrovascular complications in peritoneal dialysis patients

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图 2 IL-6表达水平与发生心脑血管并发症中位时间的Kaplan-Meier曲线分析

Figure 2. The K-M curve of IL-6 expression level and median time of the incidence of cardiovascular and cerebrovascular complications

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表 1 非心脑血管并发症组和心脑血管并发症组腹膜透析患者基线临床指标比较

Table 1. Comparison of baseline clinical parameters between non-cardiovascular, cerebrovascular complications group and cardiovascular, cerebrovascular complications group

项目	非心脑血管并发症组(n=106)	心脑血管并发症组(n=64)	统计量	P值
性别(男性/女性, 例)	54/52	34/30	0.076^a	0.783
年龄(x±s, 岁)	56.01±6.45	57.35±5.81	1.361^b	0.175
基础疾病(例)			0.001^a	0.982
慢性肾炎/高血压/糖尿病	81	49
其他	25	15
白细胞(x±s, ×10⁹/L)	9.03±1.13	8.85±1.28	0.957^b	0.340
中性粒细胞(x±s，×10⁹/L)	6.98±1.16	7.15±1.03	0.965^b	0.336
血红蛋白(x±s，g/L)	139.02±21.03	135.67±23.53	0.962^b	0.337
超敏C反应蛋白(x±s，mg/L)	13.24±2.09	25.18±4.53	23.360^b	< 0.001
ALT(x±s，U/L)	38.56±4.34	40.01±5.26	1.946^b	0.053
AST(x±s，U/L)	39.23±6.91	38.17±5.55	1.041^b	0.299
白蛋白(x±s，g/L)	34.23±5.22	35.01±5.43	0.930^b	0.354
肌酐(x±s，μmol/L)	634.23±56.34	640.09±55.28	0.662^b	0.509
尿素氮(x±s，mmol/L)	5.89±1.26	6.16±1.13	1.406^b	0.161
尿酸(x±s，μmol/L)	436.78±22.37	498.89±23.01	17.352^b	< 0.001
收缩压(x±s，mmHg)	136.68±20.05	140.28±19.67	1.142^b	0.255
舒张压(x±s，mmHg)	101.22±13.47	102.85±15.66	0.719^b	0.473
TG(x±s，mmol/L)	1.74±0.35	2.21±0.76	5.484^b	< 0.001
TC(x±s，mmol/L)	5.36±1.28	6.33±1.04	5.125^b	< 0.001
LDL-c(x±s，mmol/L)	3.85±1.04	4.59±1.12	4.366^b	< 0.001
HDL-c(x±s，mmol/L)	1.49±0.21	1.53±0.28	1.059^b	0.291
IL-6(x±s，μg/L)	89.01±13.49	136.23±16.45	20.333^b	< 0.001
注：^a为χ²值，^b为t值。1 mmHg=0.133 kPa。

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表 2 腹膜透析患者发生心脑血管并发症的logistic回归分析

Table 2. Logistic regression analysis of risk factors for cardiovascular and cerebrovascular complications in peritoneal dialysis patients

变量	B	SE	Waldχ²	P值	OR(95% CI)
超敏C反应蛋白	1.023	0.653	2.453	< 0.001	2.781(1.329~6.031)
LDL-c	0.936	0.539	3.019	< 0.001	2.551(1.498~5.005)
IL-6	1.174	0.763	2.369	< 0.001	3.236(1.295~6.982)

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