Roles of serum interleukin-6 and D-dimer levels in predicting the risk of cerebral hemorrhage in patients with hypertension

doi:10.3969/j.issn.1673-8640.2022.01.013

Abstract

Abstract:

Objective To study the roles of serum interleukin-6（IL-6） and D-dimer（DD） levels in predicting the risk of cerebral hemorrhage in patients with hypertension. Methods A total of 400 hypertensive patients were enrolled and followed up for 5 years. The serum IL-6 and DD levels were determined and compared between cerebral hemorrhage occurring group and non-occurring group. Logistic regression analysis was used to evaluate the risk factors for cerebral hemorrhage in patients with hypertension. Receiver operating characteristic（ROC） curve was used to evaluate the predictive roles of serum IL-6 and DD levels for cerebral hemorrhage. Results After 5 years of follow-up,62 cases of 400 hypertensive patients were lost to follow-up,and 32（9.47%） cases of cerebral hemorrhage occurred in the remaining 338 cases. The carotid atherosclerosis ratio,cerebral microhemorrhage ratio,serum IL-6 level,serum DD level and the course of hypertension were 87.50%,25.00%,（19.02±2.51） pg/mL,（318.40±57.85） μg/L and（12.54±2.34） years,respectively. Compared with non-occurring group,the carotid atherosclerosis and cerebral microhemorrhage ratios,serum IL-6 and DD levels and the course of hypertension were higher（χ²=15.317,P<0.001;χ²=5.872,P=0.015;t=7.915,P<0.001;t=24.694,P<0.001;t=14.753,P<0.001）. The carotid atherosclerosis,cerebral microhemorrhage,the course of hypertension,IL-6 and DD were risk factors of cerebral hemorrhage in hypertensive patients（P<0.05）. The optimal cut-off values of serum IL-6 and DD levels to predict cerebral hemorrhage in hypertensive patients were 18.35 pg/mL and 287.51 μg/L,respectively,and the areas under curves of single and combined determinations were 0.706,0.731 and 0.795,respectively. Conclusions The combined determination of serum IL-6 and DD plays a role in predicting the risk of cerebral hemorrhage in patients with hypertension,which can provide a reference for the prevention of cerebral hemorrhage.

Key words: Interleukin-6, D-dimer, Hypertension, Cerebral hemorrhage

CLC Number:

R446.1

HU Bing, LI Gai, ZHANG Huimin. Roles of serum interleukin-6 and D-dimer levels in predicting the risk of cerebral hemorrhage in patients with hypertension[J]. Laboratory Medicine, 2022, 37(1): 63-67.

Figures/Tables 4

References 19

[1]	WANG T, ZHAO Q J, GU J W, et al. Neurosurgery medical robot Remebot for the treatment of 17 patients with hypertensive intracerebral hemorrhage[J]. Int J Med Robot, 2019, 15(5):e2024.
[2]	HU S, MA Q, LI B, et al. Association of hypothyroidism with hypertensive intracerebral hemorrhage:a case-control study[J]. World Neurosurg, 2020, 134:e8-e11. DOI URL
[3]	ZHAO X H, ZHANG S Z, FENG J, et al. Efficacy of neuroendoscopic surgery versus craniotomy for supratentorial hypertensive intracerebral hemorrhage:a meta-analysis of randomized controlled trials[J]. Brain Behav, 2019, 9(12):e01471.
[4]	MENG L, BAI X, ZHENG Y, et al. Altered expression of norepinephrine transporter participate in hypertension and depression through regulated TNF-α and IL-6[J]. Clin Exp Hypertens, 2020, 42(2):181-189. DOI URL
[5]	PAULIN B K, CEDRIC K K, TAMOMH A G, et al. Assessment of cardiac biomarkers(troponin,B-type natriuretic peptide,and D-dimer) in patients with non-valvular atrial fibrillation and stroke[J]. Int J Health Sci(Qassim), 2019, 13(6):3-12.
[6]	中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中国医学前沿杂志(电子版), 2011, 3(5):42-93.
[7]	孙昭胜. 高血压性脑出血[M]. 北京: 科学技术文献出版社, 2011.
[8]	寸金芝, 赵丽琴. Morisky问卷评价精神分裂症恢复期患者服药依从性的信度和效度[J]. 临床精神医学杂志, 2016, 26(3):185-186.
[9]	CAMPBELL B C V, DE SILVA D A, MACLEOD M R, et al. Ischaemic stroke[J]. Nat Rev Dis Primers, 2019, 5(1):70. DOI URL
[10]	MAO Y, SHEN Z, ZHU H, et al. Observation on therapeutic effect of stereotactic soft channel puncture and drainage on hypertensive cerebral hemorrhage[J]. Ann Palliat Med, 2020, 9(2):339-345. DOI URL
[11]	ZIAI W C, THOMPSON C B, MAYO S, et al. Intracranial hypertension and cerebral perfusion pressure insults in adult hypertensive intraventricular hemorrhage:occurrence and associations with outcome[J]. Crit Care Med, 2019, 47(8):1125-1134. DOI URL
[12]	REZNIK M E, FAKHRI N, MOODY S, et al. Arrival blood pressure in hypertensive and non-hypertensive spontaneous intracerebral hemorrhage[J]. J Neurol Sci, 2020, 416:117000. DOI URL
[13]	LIU J, LI Q, REN J, et al. Association of sex with serum potassium,sodium,and calcium disorders after hypertensive intracerebral hemorrhage[J]. World Neurosurg, 2020, 141:e367-e373. DOI URL
[14]	LEASURE A C, SHETH K N. Resuming anticoagulation after cerebral intraparenchymal hemorrhage[J]. JAMA, 2019, 322(7):694.
[15]	陈勇, 陈琳, 徐冬, 等. 依达拉奉联合鼠神经生长因子治疗老年高血压脑出血的临床效果及对血清NSE、IL-6、IL-8、hs-CRP的影响分析[J]. 华南国防医学杂志, 2019, 33(3):166-169.
[16]	董蔚蔚, 李新星, 王文卿, 等. 血清D-二聚体水平与急性脑出血疾病严重程度及早期预后的关系[J]. 临床神经病学杂志, 2018, 31(3):219-221.
[17]	MOCKER A, HILGERS K F, CORDASIC N, et al. Renal chemerin expression is induced in models of hypertensive nephropathy and glomerulonephritis and correlates with markers of inflammation and fibrosis[J]. Int J Mol Sci, 2019, 20(24):6240. DOI URL
[18]	SALIBA L J, MAFFETT S. Hypertensive heart disease and obesity:a review[J]. Heart Fail Clin, 2019, 15(4):509-517. DOI URL
[19]	程云龙, 于林, 李双法, 等. 人血清白细胞介素6水平稳定性研究[J]. 检验医学, 2019, 34(2):185-186.

组别	例数	性别					年龄/岁			BMI/（kg/m²）				吸烟/例		饮酒/例		高盐饮食/例			高脂饮食/例
组别	例数	男性/例		女性/例			年龄/岁			BMI/（kg/m²）				吸烟/例		饮酒/例		高盐饮食/例			高脂饮食/例
发生脑出血组	32	23		9			67.52±9.48			26.41±1.87				12		10		17			18
未发生脑出血组	306	170		136			66.85±9.50			26.03±1.79				74		65		145			138
统计值		3.150					0.380			1.138				2.708		1.681		0.382			1.450
P值		0.076					0.704			0.256				0.100		0.195		0.536			0.229
组别	失眠/例		便秘/例			糖尿病/例		脑血管病家族史/例				颈动脉粥样硬化/例							脑微出血/例		冠心病史/例
发生脑出血组	9		10			7		13				28							8		8
未发生脑出血组	70		78			50		79				157							32		59
统计值	0.446		0.499			0.633		3.207				15.317							5.872		0.596
P值	0.504		0.480			0.426		0.073				<0.001							0.015		0.440
组别	高脂血症/ 例				高尿酸血症/ 例				高血压病程/年		高血压分级						服药依从性/分			IL-6/ （pg/mL）	DD/（μg/L）
组别	高脂血症/ 例				高尿酸血症/ 例				高血压病程/年		Ⅰ级/例		Ⅱ级/例		Ⅲ级/例		服药依从性/分			IL-6/ （pg/mL）	DD/（μg/L）
发生脑出血组	7				6				12.54±2.34		9		17		16		6.53±0.89			19.02±2.51	318.40±57.85
未发生脑出血组	56				48				9.24±1.02		115		132		59		6.83±0.84			15.74±2.20	167.05±28.86
统计值	0.244				0.203				14.753		0.403						1.912			7.915	24.694
P值	0.621				0.653				<0.001		0.526						0.057			<0.001	<0.001

组别	例数	性别					年龄/岁			BMI/（kg/m²）				吸烟/例		饮酒/例		高盐饮食/例			高脂饮食/例
组别	例数	男性/例		女性/例			年龄/岁			BMI/（kg/m²）				吸烟/例		饮酒/例		高盐饮食/例			高脂饮食/例
发生脑出血组	32	23		9			67.52±9.48			26.41±1.87				12		10		17			18
未发生脑出血组	306	170		136			66.85±9.50			26.03±1.79				74		65		145			138
统计值		3.150					0.380			1.138				2.708		1.681		0.382			1.450
P值		0.076					0.704			0.256				0.100		0.195		0.536			0.229
组别	失眠/例		便秘/例			糖尿病/例		脑血管病家族史/例				颈动脉粥样硬化/例							脑微出血/例		冠心病史/例
发生脑出血组	9		10			7		13				28							8		8
未发生脑出血组	70		78			50		79				157							32		59
统计值	0.446		0.499			0.633		3.207				15.317							5.872		0.596
P值	0.504		0.480			0.426		0.073				<0.001							0.015		0.440
组别	高脂血症/ 例				高尿酸血症/ 例				高血压病程/年		高血压分级						服药依从性/分			IL-6/ （pg/mL）	DD/（μg/L）
组别	高脂血症/ 例				高尿酸血症/ 例				高血压病程/年		Ⅰ级/例		Ⅱ级/例		Ⅲ级/例		服药依从性/分			IL-6/ （pg/mL）	DD/（μg/L）
发生脑出血组	7				6				12.54±2.34		9		17		16		6.53±0.89			19.02±2.51	318.40±57.85
未发生脑出血组	56				48				9.24±1.02		115		132		59		6.83±0.84			15.74±2.20	167.05±28.86
统计值	0.244				0.203				14.753		0.403						1.912			7.915	24.694
P值	0.621				0.653				<0.001		0.526						0.057			<0.001	<0.001

项目	β值	标准误	Wald 值	P值	比值比值	95%可信区间
颈动脉粥样硬化	0.809	0.298	7.370	0.003	2.246	1.687~2.804
脑微出血	1.147	0.452	6.439	0.005	3.149	2.055~4.242
高血压病程	1.508	0.324	21.663	<0.001	4.518	3.014~6.021
IL-6	1.340	0.416	10.376	0.002	3.819	2.016~5.622
DD	1.724	0.357	23.321	<0.001	5.607	4.251~6.963

项目	β值	标准误	Wald 值	P值	比值比值	95%可信区间
颈动脉粥样硬化	0.809	0.298	7.370	0.003	2.246	1.687~2.804
脑微出血	1.147	0.452	6.439	0.005	3.149	2.055~4.242
高血压病程	1.508	0.324	21.663	<0.001	4.518	3.014~6.021
IL-6	1.340	0.416	10.376	0.002	3.819	2.016~5.622
DD	1.724	0.357	23.321	<0.001	5.607	4.251~6.963

项目	曲线下面积（95%可信区间）	最佳临界值	敏感性/%	特异性/%	准确性/%
IL-6	0.706（0.652~0.760）	18.35 pg/mL	78.13	70.26	71.01
DD	0.731（0.630~0.832）	287.51 μg/L	71.88	77.45	76.92
IL-6+DD	0.795（0.747~0.843）		71.88	79.08	78.40