| 费忠化,于江,蔡国强,蔡腾,刘宏生.白细胞介素-32对急性心肌梗死后心力衰竭的预测价值[J].济宁医学院学报,2024,47(6):471-475 |
| 白细胞介素-32对急性心肌梗死后心力衰竭的预测价值 |
| Predictive value of interleukin-32 on heart failure after acute myocardial infarction |
| 投稿时间：2023-05-20 |
| DOI：10.3969/j.issn.1000-9760.2024.06.003 |
| 中文关键词: 白细胞介素-32;冠心病;急性心肌梗死;心力衰竭 |
| 英文关键词: Interleukin-32;Coronary heart disease;Acute myocardial infarction;Heart failure |
| 基金项目:山东省自然科学基金项目(ZR2021MH346);山东省高等学校科技计划项目 (J17KA231);济宁市重点研发项目(2022YXNS040) |
| 作者 | 单位 | | 费忠化 | 济宁医学院附属医院心脏重症医学科, 济宁 272029 | | 于江 | 济宁医学院附属医院检验科, 济宁 272029 | | 蔡国强 | 济宁医学院附属医院心脏重症医学科, 济宁 272029 | | 蔡腾 | 济宁医学院附属医院心脏重症医学科, 济宁 272029 | | 刘宏生 | 济宁医学院附属医院心脏重症医学科, 济宁 272029 |
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| 中文摘要: |
| 目的 探讨白细胞介素-32(IL-32)与急性心肌梗死(AMI)后心力衰竭(HF)的关系,评价其预测心衰的价值。方法 选择2021年1月至6月我院住院AMI患者100例,采用ELISA方法测定患者发病后12h内血清IL-32、白细胞介素-6(IL-6)、金属基质蛋白酶-9(MMP-9)表达水平等临床指标,并测量AMI患者发病后6月B型钠尿肽(BNP)表达水平、左室射血分数(LVEF)和左室舒张末内径(LVEDD),根据LVEF分为心衰组(LVEF＜50%,35例)和对照组(LVEF≥50%,65例),比较两组资料,采用多因素logistic回归分析HF的危险因素,通过受试者工作曲线(ROC)分析IL-32对HF的预测价值。结果 心衰组患者高血压占比、IL-32表达水平、BNP、LVEDD均明显高于对照组(P＜0.05),总胆固醇低于对照组;IL-32表达水平与IL-6表达水平、LVEDD、BNP表达水平呈正相关(r1=0.249,P1=0.016;r2=0.286,P2=0.010;r3=0.448,P3=0.001),与LVEF呈负相关(r=-0.752,P=0.001);多因素logistic回归分析,IL-32(OR=1.077,95%CI=1.028~1.127,P=0.002)、BNP(OR=1.002,95%CI=1.000~1.004,P=0.024)是AMI后HF的独立危险因素;IL-32预测HF的曲线下面积(AUC)为0.832(95%CI=0.738～0.926,P＜0.05),敏感度69.7%,特异度91.8%,最佳截断值50.219pg/mL;IL-32联合BNP预测HF的AUC提升至0.894(95%CI=0.825～0.964,P＜0.05),敏感度66.7%,特异度95.4%。结论 AMI后HF IL-32表达水平明显升高,IL-32对预测AMI后HF具有一定的应用价值。 |
| 英文摘要: |
| Objective To investigate the relationship and the predictive value of interleukin-32 (IL-32) in heart failure (HF) after acute myocardial infarction (AMI). Methods 100 patients with AMI hospitalized in our hospital from January to June 2021 were selected as research objects.The expression levels of serum IL-32,interleukin-6 (IL-6) and matrix metalloproteinase-9 (MMP-9) within AMI 12 hours were measured by ELISA,and the B-type natriuretic peptide (BNP),left ventricular ejection fraction (LVEF) and left ventricular end-diastolic inner diameter (LVEDD) were measured with AMI 6 months after onset.According to LVEF,patients were divided into heart failure group (LVEF＜50%,n=35) and control group (LVEF≥50%,n=65).The risk factors of heart failure after AMI were analyzed by univariate and multivariate logistic regression.The predictive value of IL-32 for HF was analyzed by the receiver operating curve (ROC). Results The proportion of hypertension,IL-32 expression level,BNP and LVEDD in the heart failure group were significantly higher than those in the control group (P＜0.05),and the total cholesterol was lower than that in the control group.After myocardial infarction,IL-32 expression was positively correlated with IL-6 expression,LVEDD,and BNP (r1=0.249,P=0.016;r2=0.286,P=0.010;r3=0.448,P=0.001),and was negatively correlated with LVEF (r4=-0.752,P=0.001).Multivariate logistic regression analysis showed that IL-32 (OR=1.077,95%CI=1.028~1.127,P=0.002),BNP (OR=1.002,95%CI=1.000~1.004,P=0.024) were independent risk factors for HF after AMI.The area under the ROC curve(AUC) of IL-32 in predicting heart failure after AMI was 0.832(95%CI=0.738～0.926,P＜0.05),the diagnostic sensitivity was 0.697 and the specificity was 0.918,the best cut-off value was 50.219pg/mL.The AUC of IL-32 plus BNP in predicting heart failure after AMI was 0.894 (95%CI=0.825～0.964,P＜0.05),with a sensitivity of 0.667 and specificity of 0.954. Conclusion IL-32 expression was significantly increased in patients with heart failure after AMI.IL-32 has certain application value in predicting cardiac insufficiency after AMI. |
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