关键词: 急性心肌梗死, 住院死亡率, 炎症因子, 白细胞介素-6, 可溶性细胞间黏附分子-1, 可溶性血管细胞黏附分子-1, 可溶性P选择素

Abstract: Objective The aim of the present study is to assess the prognostic value of serum interleukin-6(IL-6),soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1) and soluble P-selectin(sP-selectin) on in-hospital mortality in patients with ST-segment elevation acute myocardial infarction(STEMI).Methods The single-centre study enrolled 263 consecutive patients with STEMI.Data on patients' histories,comorbidity,presenting features and reperfusion treatments were collected.In all patients a venous blood sample was taken within 6 hours after symptom onset.Serum levels of IL-6,sICAM-1,sVCAM-1 and sP-selectin were measured by ELISA method.The relation among these inflammatory factors,clinical characteristics and in-hospital mortality were observed and analyzed by SPSS 11.5 package.Results A total of 18 patients died during hospitalization,with a mortality rate of 6.84%.Patients of death group were substantially older than those survival(70.06 vs 60.44,P<0.001),had a higher incidence of hypertension(P<0.016) and diabetes mellitus(P<0.043),and a lower body mass index(BMI)(P<0.034).The proportion of female in death group was higher(P<0.048).Serum levels of IL-6 in death group were higher than those in survival group(P<0.001).No significant difference of sICAM-1,sVCAM-1 and sP-selectin levels between the two groups was found.ROC curve analysis to predict the risk for in-hospital mortality showed a prognostic accuracy of IL-6(AUC 0.787,95% CI:0.678～0.897,P<0.001),the optimal cutoff value was 7.082 ng/L.Predictors of in-hospital mortality at multivariable logistic analysis were IL-6 levels and age(P=0.019 and 0.049,respectively).Conclusion IL-6 levels and age were related to in-hospital mortality of ST-segment elevation acute myocardial infarction,both are independent predictor of in-hospital death in patients with STEMI.

Key words: acute myocardial infarction, in-hospital mortality, inflammatory factors, interleukin-6, soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, soluble P-selectin