Clinical diagnostic value of inflammatory markers in toxic pathogen syndrome of coronary heart disease with heart failure

LAI Haixia; NIU Chaofeng; XIAO Di; LI Meng; WANG Ce; LIU Jiashang; ZHANG Lijing

doi:10.16025/j.1674-1307.2025.09.022

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Clinical diagnostic value of inflammatory markers in toxic pathogen syndrome of coronary heart disease with heart failure

更新时间：2025-11-25

- Clinical diagnostic value of inflammatory markers in toxic pathogen syndrome of coronary heart disease with heart failure
- Beijing Journal of Traditional Chinese Medicine Vol. 44, Issue 9, Pages: 1189-1194(2025)
- 作者机构：
  
  北京中医药大学东直门医院心血管内科，北京，100700
- 作者简介：
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.09.022
  CLC：
- Received：25 March 2025，
  
  Published：25 September 2025
- 稿件说明：
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赖海霞，牛超峰，肖狄，等.炎症指标对冠心病心力衰竭毒邪证诊断的作用研究［J］.北京中医药，2025，44（9）：1189-1194.

LAI Haixia,NIU Chaofeng,XIAO Di,et al.Clinical diagnostic value of inflammatory markers in toxic pathogen syndrome of coronary heart disease with heart failure[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(09):1189-1194.
赖海霞，牛超峰，肖狄，等.炎症指标对冠心病心力衰竭毒邪证诊断的作用研究［J］.北京中医药，2025，44（9）：1189-1194. DOI： 10.16025/j.1674-1307.2025.09.022.

LAI Haixia,NIU Chaofeng,XIAO Di,et al.Clinical diagnostic value of inflammatory markers in toxic pathogen syndrome of coronary heart disease with heart failure[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(09):1189-1194. DOI： 10.16025/j.1674-1307.2025.09.022.

摘要

目的

探讨炎症指标对冠心病心力衰竭毒邪证的诊断价值，为冠心病心力衰竭患者的治疗管理提供依据。

方法

纳入2023年5月1日—2024年4月30日在北京中医药大学东直门医院及各分中心（辽宁中医药大学附属医院、中国中医科学院广安门医院、广州中医药大学第一附属医院）心内科门诊和住院部就诊的冠心病心力衰竭患者共397例，根据证型分为毒邪证组（177例）和非毒邪证组（220例），比较2组患者炎症指标［白细胞（WBC）、血小板（PLT）、中性粒细胞（NEUT）、淋巴细胞（LYMP）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、纤维蛋白原（FIB）、高敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、系统性免疫炎症指数（SII）］的差异。采用二分类Logistic回归模型筛选独立危险因素，绘制受试者工作特征（ROC）曲线，并计算曲线下面积（AUC）评估指标的诊断价值。

结果

毒邪证组NYHA Ⅳ级患者比例及hs-CRP、IL-6、NLR、SII均高于非毒邪证组（

0.05）。IL-6水平升高是毒邪证的独立危险因素（

=0.028，

=1.017，95%

1.002~1.033）；IL-6诊断

冠心病心力衰竭毒邪证的AUC为0.665，最佳截断值为6.145 pg/mL，此时的灵敏度为63.84%，特异度为68.64%。

结论

冠心病心力衰竭毒邪证患者的炎症指标更高，其中IL-6最为显著，有一定的临床诊断价值。

Abstract

Objective

To investigate the diagnostic value of inflammatory markers for toxic pathogen syndrome in patients with coronary heart disease （CHD） complicated by heart failure， providing evidence for clinical treatment and management.

Method

A total of 397 patients with CHD and heart failure who visited the cardiology outpatient and inpatient departments of Dongzhimen Hospital， Beijing University of Chinese Medicine， and its affiliated centers （The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine， Guang'anmen Hospital of China Academy of Chinese Medical Sciences， and The First Affiliated Hospital of Guangzhou University of Chinese Medicine） from May 1， 2023， to April 30， 2024， were enrolled and classified by TCM syndrome differentiation into a toxic pathogen syndrome group （

= 177） and a non-toxic pathogen syndrome group （

= 220）. Differences in inflammatory markers， including white blood cell count （WBC）， platelet count （PLT）， neutrophil count （NEUT）， lymphocyte count （LYMP）， neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， fibrinogen （FIB）， high-sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）， and systemic immune-inflammation index （SII）， were compared. Binary logistic regression analysis was performed to identify independent risk factors. Receiver operating characteristic （ROC） curves were plotted， and the area under the curve （AUC） was calculated to assess diagnostic value.

Results

The proportion of NYHA class IV patients and levels of hs-CRP， IL-6， NLR， and SII were significantly higher in the toxic pathogen syndrome group than in the non-toxic pathogen syndrome group （all

0.05）. Eleva

ted IL-6 was identified as an independent risk factor for toxic pathogen syndrome （

= 0.028；

= 1.017； 95%

1.002~1.033）. The ROC curve analysis showed an AUC of 0.665 for IL-6 in diagnosing toxic pathogen syndrome， with an optimal cutoff value of 6.145 pg/mL， yielding a sensitivity of 63.84% and specificity of 68.64%.

Conclusion

Patients with CHD and heart failure presenting with toxic pathogen syndrome exhibit higher levels of inflammatory markers， among which IL-6 is the most significant and has certain clinical diagnostic value.

关键词

Keywords

references

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