Analysis Of The Effect Of Baseline IL-6 Levels On The Severity And Prognosis Of Patients With Chronic Heart Failure

Objective:To investigate the value of interleukin-6 in risk stratification and prognost-ic evaluation of the chronic heart failure, which can provide a new basis to the diagnosis, prognosis and treatment areas in the chronic heart failure.Materials and methods:1. General information: 70 patients were selected with heart failure of hos-pitalized grade NYHA II-IV, males with 58 cases and females with 12 cases,mean age(61±12) years, age ranges(29-82) years.2. Relevant inspection: Blood, urine and liver and kidney function tests, el-ectrocardiogram, echocardiography, chest X-ray and other related inspection we re processed after admission, and detected the BNP and interleukin-6 levels.3. Statistical methods: Analyzed by SPSS 16.0 software, measurement data using mean and standard deviation which meet the normal distribution, others using mean and inter-quatile represent which do not meet the normal distribut-ion. First we test of normality as with α=0.05 significance level. After analysi-s, index variables meet normal distribution are baseline LVEF(Z=1.169 P=0.130), early treatment of LVEF(Z=0.731 P=0.659), advanced treatment of LVEF(Z=0.566 P=0.905), baseline EDD(Z=0.889 P=0.408), early treatment of EDD(Z=1.076 P=0.197) and advanced treatment of EDD(Z=1.084 P=0.190), and ot-hers satisfy variable distribution. Baseline IL-6 average 1.37(0.43, 2.69), basel-ine NYHA average 3.00(2.00, 3.00), baseline LVEF average(22.62±8.27), bas-eline BNP average 159.00(69.70, 401.00), baseline EDD average(6.67±0.74);early treatment of IL-6 average 1.21(0.34, 2.20), early treatment of NYHA a-verage 2.00(2.00, 3.00), early treatment of LVEF average(28.58±10.20), early treatment of BNP average 122.00(53.28, 321.25), early treatment of EDD ave-rage(6.30±0.96); late treatment of IL-6 average 1.21(0.34, 2.20), late treatme-nt of NYHA average 2.00(2.00, 3.00), late treatment of LVEF average(28.58±10.20), late treatment of BNP average 122.00(53.28, 321.25), late treatment o-f EDD average(6.30±0.96).Correlation analysis between two variables the following principles:to meet double the normal distribution of variables,linear correlation analysis applicatio-n,two to meet the two-normally distribution variables,application spearman rank correlation analysiss. The comparison of mortality between the group IL-6≤1.34pg/ml(n=34) and the group IL-6>1.34pg/ml(n=34) use the chi-square test.Compared with other data between the two groups according to the following principle: If two sets of data are in line with normal application compare means Independent T test, there is a non-normal distribution or normal distribution compare means nonparametric test for two do not meet the rank sum test. Statistical results sided P <0.05 was considered statistically significant difference.Results:1. The correlation analysis of the baseline IL-6 with baseline NYHA, base-line LVEF、 baseline BNP and baseline EDD.The baseline IL-6 to baseline NYHA was significantly positively correlated(r=0.454, P<0.01), the baseline IL-6 to baseline LVEF did negative associate d(r=-0.530, P<0.01), the baseline IL-6 to baseline BNP was significantly posi-tively correlated(r=0.502, P<0.01), the baseline IL-6 to baseline EDD was si-gnificantly positively correlated(r=0.378, P<0.01).2. The correlation analysis of the baseline IL-6、cardiac function with the IL-6 levels、cardiac function of standard drug treatment for 4 weeks(early trea-tment) and standard drug treatment for 16-48 weeks(late treatment).The chronic heart failure who were progressed by the treatment of standar-d drug, displayed that cardiac function improved significantly, IL-6 level no difference.3. Statistically analyzed IL-6 level between the two groups of mild heart f-ailure(NYHA Ⅱ) and moderate to severe heart failure(NYHA Ⅲ, Ⅳ).The difference of IL-6 level between mild heart failure(NYHA Ⅱ) and moderate to severe heart failure(NYHA Ⅲ, Ⅳ) did have great statistical signi-ficance(P<0.01). As the mean rank of the moderate to severe heart failure g-roup(41.56) was higher than the mild heart failure group(22.36).Therefore, the IL-6 level in the moderate to severe heart failure group wa-s higher than the mild heart failure group.4. The statistical analysis of the levels of the IL-6 in different causes of heart failure.Take comparison with IL-6 levels in a variety of causes of heart failure(dilated cardiomyopathy, ischemic heart disease etc.).Data test results showed that the difference between groups were not signi-ficant(P = 0.835).5. The influences of baseline IL-6 levels on the long-term prognosis for p-atients.Using the content in the blood of the 1ng/L baseline IL-6 level as the cut off point. Sourcebook was divided into IL-6≤1.34pg/ml group(n=34) and IL-6>1.34pg/ml group(n=34). Then comparing mortality differences between the two groups we concluded that Pearson chi-square value was 5.100,P=0.025。two groups were statistically significant differences in mortality.Thus, IL-6>1.34pg/ml group(20.59%) has a higher mortality rate against IL-6≤1.34pg/ml group(2.94%).Conclusion:1. There were no statistically significant differences in different causes of heart failure against the levels of IL-6.2. Patients elevated levels of interleukin-6 showed left ventricular dysfuncti-on, manifested as NYHA class increased, LVEF decreased, BNP increased, left ventricular end-diastolic volume increased.3. The level of interleukin-6 turned a downward trend, after standardized drug treatment progressed on the chronic heart failure patients.4. High IL-6 group had a high long-term mortality than the low IL-6 group.5. Levels of baseline interleukin-6 can used to be determined the severity-of heart failure and prognosis of heart failure.