介素-6,C-反应蛋白与慢性病结局之间的关联:系统性审查和元分析
Sama Mahmoud Abdel-Rahman1, Lasin Ozbek1, Arif E Narin1
1Koc University, School of Medicine, Istanbul, Turkey.
European journal of internal medicine
|December 25, 2025
概括
在慢性病 (CKD) 中,高水平的介质素-6 (IL-6),C反应蛋白 (CRP) 和高敏感性CRP (hs-CRP) 与较高的死亡率和心血管风险有关. 证据的确定性很低,需要对这些炎症生物标志物进行谨慎的解释.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 炎症生物学 炎症生物学
背景情况:
- 慢性病 (CKD) 的特点是系统性炎症.
- 像IL-6,CRP和hs-CRP这样的炎症生物标志物与CKD不良结果有关.
- 这些生物标志物协会的临床相关性和一致性需要进一步研究.
研究的目的:
- 系统地审查和元分析IL-6,CRP,hs-CRP和CKD患者的不良结果之间的关联.
- 量化与这些炎症标志物水平升高相关的死亡率和心血管事件风险.
- 评估这些关联的证据的确定性.
主要方法:
- 81项研究的系统综述和元分析.
- 在主要数据库 (PubMed,科学网,Scopus,Ovid MEDLINE,Cochrane图书馆) 进行的搜索,截至2024年10月.
- 随机效应元分析用于汇集危险比率 (HRs);使用I2和Cochran的Q测试评估异质性.
主要成果:
- 持续升高的IL-6,CRP和hs-CRP与所有原因死亡率,心血管死亡率和心血管事件的增加有关.
- 综合所有原因死亡率的HRs:IL-6 (1.52),CRP (1.63),hs-CRP (1.15). 在所有原因死亡率的HRs中,IL-6 (1.52),CRP (1.63),hs-CRP (1.15).
- 观察到实质性的异质性 (I2>70%),预测间隔为95%,这表明研究之间存在相当大的变化.
结论:
- 较高的IL-6,CRP和hs-CRP水平与慢性瘤中死亡率和心血管结果的风险增加有关.
- 证据基础是观测和异质的,导致低至非常低的GRADE确定性.
- 这些生物标志物可能有助于描述CKD的炎症风险,但应谨慎使用它们作为辅助信号,而不是独立的工具.
相关概念视频
01:24Chronic Kidney Disease II: Clinical Manifestations
520
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
520
01:28Chronic Kidney Disease III: Interprofessional Care
319
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
319
01:29Acute Kidney Injury II: Pathophysiology
840
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
840
01:22Acute Kidney Injury I: Introduction
511
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
511
01:25Chronic Kidney Disease I: Introduction
536
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
536
01:29Acute Kidney Injury III: Clinical Manifestations
763
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
763