Interleukin-8 is a powerful prognostic predictor of all-cause and cardiovascular mortality in dialytic patients
Interleukin-8 is a powerful prognostic predictor of all-cause and cardiovascular mortality in dialytic patients
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DOI：
10.1159/000088923
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发表时间：
2006-01-01
影响因子：
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通讯作者：
Tetta, C
中科院分区：
文献类型：
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作者：
Panichi, V;Taccola, D;Tetta, C
背景：队列研究已经证明c反应蛋白（CRP）和白细胞介素-6 （IL- 6）与终末期肾病（ESRD）患者的全因死亡率和心血管死亡率之间存在关联。白细胞介素-8 （IL-8）似乎不仅是急性期反应的血浆表达，也是动脉粥样硬化过程的直接致病介质。方法：对76例慢性透析患者进行为期18个月的前瞻性随访，以评价IL-8对预后的预测作用。在基线时，采集血液样本进行高敏CRP、IL- 6、IL- 8和其他标准实验室分析。结果：中位IL-8为5.2 mg/l，因此近一半患者的IL-8值在“正常限度”范围内。IL-6与CRP呈显著相关（r = 0.45, p < 0.001）， IL-6与IL-8呈显著正相关（r = 0.39, p < 0.001）。在无心血管病史和/或有临床症状的患者中，IL- 6与CRP的相关系数分别为0.43 （p < 0.001）和0.50 （p < 0.001）。随访1年半后，8例患者死于心血管原因，7例患者死于其他原因；此外，还记录了9例主要非致死性心血管事件。逐步回归分析显示，即使在调整年龄和透析年龄后，IL-8仍是全因事件和心血管事件的最强独立预测因子（p = 0.0025），其次是IL- 6和CRP （p < 0.01）。结论：尽管研究对象较少，随访时间相对较短，但本研究首次证明了IL-8是ESRD患者心血管和总死亡率的一个强有力的独立预测因素。
Background: Cohort studies have demonstrated an association between C-reactive protein (CRP) and interleukin-6 (IL- 6) and all-cause and cardiovascular mortality in end-stage renal disease (ESRD) patients. Interleukin-8 ( IL-8) appears to be not only the plasma expression of the acute-phase response but also a direct pathogenetic mediator of the atherosclerotic process. Methods: To evaluate the role of IL-8 in predicting outcome, 76 chronic dialytic patients were prospectively followed for 18 months. At baseline, blood samples were taken for analysis of high-sensitivity CRP, IL- 6, IL- 8 and other standard laboratory analyses. Results: Median IL- 8 was 5.2 mg/l, therefore near half of the patients had IL-8 values within the range of 'normal limits'. IL-6 and CRP were significantly correlated (r = 0.45, p < 0.001) and a positive correlation was also found between IL-6 and IL-8 (r = 0.39, p < 0.001). The correlation coefficient between IL- 6 and CRP was 0.43 (p < 0.001) and 0.50 (p < 0.001) in patients without and with history and/ or clinical signs of cardiovascular disease, respectively. After a follow-up of 1.5 years, 8 patients had died from cardiovascular causes and another 7 patients for other reasons; furthermore 9 major nonfatal cardiovascular events were recorded. Stepwise regression analysis showed IL-8 as the strongest independent predictor of all-cause and cardiovascular events (p = 0.0025) even after adjustment for age and dialytic age, followed by IL- 6 and CRP (p < 0.01). Conclusion: Despite a small population and a relatively short follow- up period, this study firstly demonstrated that IL-8 is a powerful independent predictive factor for cardiovascular and overall mortality cause in ESRD patients.