1、147现代检验医学杂志第 38 卷第 1 期2023 年 1 月J Mod Lab Med,Vol.38,No.1,Jan.2023血清 MAO 和 IL-6 水平诊断慢性肾衰竭并发心力衰竭的 价值及与心功能分级的关系李丽霞,李娜（邯郸明仁医院检验科，河北邯郸 056002）摘要：目的研究血清单胺氧化酶（monoamine oxidase，MAO）、白细胞介素（interleukin，IL）-6 水平与慢性肾衰竭（chronic renal failure）并发心力衰竭（heart failure）患者心功能分级的相关性。方法选择 2021 年 6 月 2022年 5 月邯郸明仁医院肾病科及透
2、析中心慢性肾衰竭并发心力衰竭患者 80 例作为试验组，按照美国纽约心脏病学会（New York Heart Association，NYHA）分级将试验组患者分为：心功能 I 级 20 例，心功能 II 级 20 例，心功能 III 级20 例和心功能 IV 级 20 例，同期选择单纯慢性肾衰竭患者 80 例作为对照 A 组，健康体检者 80 例作为对照 B 组，分别测定各组的血清 MAO，IL-6 和 N-末端 B 型钠尿肽前体（N-terminal B-type natriuretic peptide precursor，NT-proBNP）水平，分析其与慢性肾衰竭并发心力衰竭患者心功能分
3、级的关系。其中试验组、对照 A 组符合疾病诊断标准，经各项检查确诊，且病情稳定，实验前均未接受治疗，另外所有观察对象与家属签订知情书。结果试验组 MAO（8.561.85U/L），IL-6（128.5617.48ng/L）和 NT-proBNP（872.0411.25pg/ml）水平均高于对照 A 组（3.141.01U/L，97.4212.36ng/L，195.796.87pg/ml）和 对 照 B 组（2.870.85U/L，77.698.15ng/L，66.045.48pg/ml），差异均具有统计学意义（F=478.790，300.850，220 577.310，均 P 0.05）。心功
4、能 I 级 MAO，IL-6，NT-proBNP 水平分别为 3.771.05U/L，104.2615.47ng/L 和 381.258.44pg/ml，心功能 II 级 MAO，IL-6，NT-proBNP 水平分别为5.261.35U/L，113.1516.89ng/L和579.3110.10pg/ml，心功能III级MAO，IL-6，NT-proBNP水平分别为7.482.09U/L，125.7317.02ng/L 和 782.0811.24pg/ml，心 功 能 IV 级 MAO，IL-6，NT-proBNP 水 平 分 别 为 8.992.67U/L，130.5817.96ng/L，
5、901.5412.10pg/ml，试验组中心功能IV级患者的血清MAO，IL-6，NT-proBNP水平均高出心功能I，II，III 级患者，差异具有统计学意义（F=29.750，172.220，9 414.430,均 P 0.05）。联合诊断的敏感度（97.50%）、特异度（95.00%）、ROC 曲线下面积（0.893）高出单一 MAO（86.25%，83.75%，0.600）和 IL-6（87.50%，83.75%，0.580），差异具有统计学意义（2=0.004，7.207，6.664，均 P 0.05）。血清 MAO，IL-6，NT-proBNP 指标均与慢性肾衰竭并发心力衰竭患者心
6、功能分级呈现正相关性（r=0.562 0.781，P 0.05）。结论血清 MAO，IL-6 与慢性肾衰竭并发心力衰竭患者心功能分级存在密切关联性，不仅能够诊断疾病，同时还可对心功能分级进行评估，另外联合诊断的敏感度以及特异度更高。关键词：心力衰竭；心功能分级；单胺氧化酶；慢性肾衰竭中图分类号：R692.5；R392.11文献标识码：A文章编号:1671-7414（2023）01-147-05doi:10.3969/j.issn.1671-7414.2023.01.027Value of Serum MAO and IL-6 Levels in the Diagnosis of Chronic
7、 Renal Failure Complicated with Heart Failure and Their Relationship with Cardiac Function GradingLI Li-xia,LI Na（Department of Clinical Laboratory,Handan Mingren Hospital，Hebei Handan 056002，China）Abstract:Objective To study the correlation of serum monoamine oxidase(MAO)and interleukin-6(IL-6)leve
8、ls with cardiac function classifications in chronic renal failure patients with heart failure.Methods80 chronic renal failure patients with heart failure treated from June 2021 to May 2022 in Nephrology and Dialysis Department of Handan Mingren Hospital were chosen as experimental group.According to
9、 New York Heart Association(NYHA),the experimental group was assigned to grade I group(20 cases),grade II group(20 cases),grade III group(20 cases)and grade IV group(20 cases).Over the same time period,80 chronic renal failure patients were set as control group A.80 healthy checkups were set as cont
10、rol group B.Serum MAO,IL-6 and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels were measured,and analyze its correlations with cardiac function classifications.Among them,the test group and the control group A met the disease diagnostic criteria;were confirmed by various examinutions,and w
11、ere in a stable comdition,and did not receive treatment before the experiment.In addition,all the 基金项目：河北省卫生健康委医学课题计划项目（20211402）。作者简介：李丽霞（1980-），女，汉族，本科，主管检验师，研究方向：临床检验。通讯作者：李娜（1981-），女，本科，主管检验师，E-mail：。148现代检验医学杂志第 38 卷第 1 期2023 年 1 月J Mod Lab Med,Vol.38,No.1,Jan.2023observation objects signed a l
12、ove letter with their familes receive the therapy;the research subjects and their family members had signed the informed consent forms.ResultsSerum MAO(8.561.85U/L),IL-6(128.5617.48ng/L)and NT-proBNP(872.0411.25pg/ml)levels in the experimental group were,and which were significantly higher than thos
13、e of control group A(3.141.01U/L,97.4212.36ng/L,195.796.87pg/ml)and control group B(2.870.85U/L,77.698.15ng/L,66.045.48pg/ml)，the differences were statistically significant（F=478.790，300.850，220 577.310，all P 0.05）.Serum MAO,IL-6 and NT-proBNP levels in grade I group were 3.771.05U/L,104.2615.47ng/L
14、 and 381.258.44pg/ml，respectively.Serum MAO,IL-6 and NT-proBNP levels in grade II group were 5.261.35U/L,113.1516.89ng/L and 579.3110.10pg/ml，respectively.Serum MAO,IL-6 and NT-proBNP levels in grade III group were 7.482.09U/L,125.7317.02ng/L and 782.0811.24pg/ml，respectively.Serum MAO,IL-6 and NT-p
15、roBNP levels in grade IV group were 8.992.67U/L,130.5817.96ng/L and 901.5412.10 pg/ml，respectively.Serum MAO,IL-6 and NT-proBNP levels in grade IV group were significantly higher than grade I group,grade II group and grade III group（F=29.750，172.220，9 414.430,all P 0.05）.The diagnosis sensitivity（97
16、.50%）,specificity（95.00%）and area under ROC（0.893）curve based on combined examination were higher than those based on MAO（86.25%，83.75%，0.600）or IL-6（87.50%，83.75%，0.580）,the differences were statistically significant（2=0.004，7.207，6.664，all P 0.05）.Serum MAO,IL-6 and NT-proBNP levels were positively correlated with cardiac function classifications for chronic renal failure patients with heart failure(r=0.562 0.781，all P 0.05).ConclusionSerum MAO and IL-6 levels were closely correlated with card
