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 afteracute myocardial infarction

作　　者：费忠化[1] 于江[2] 蔡国强[1] 蔡腾 刘宏生[1] FEI Zhonghua;YU Jiang;CAI Guoqiang;CAI Teng;LIU Hongsheng(Department of Cardiovascular ICU,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Clinical Laboratory,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院心脏重症医学科 [2]济宁医学院附属医院检验科,济宁272029

出　　处：《济宁医学院学报》2024年第6期471-475,共5页Journal of Jining Medical University

基　　金：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)。

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(r_(1)=0.249,P_(1)=0.016;r_(2)=0.286,P 2=0.010;r_(3)=0.448,P_(3)=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。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(r_(1)=0.249,P=0.016;r_(2)=0.286,P=0.010;r_(3)=0.448,P=0.001),and was negatively correlated with LVEF(r_(4)=-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 valu

关 键 词：白细胞介素-32 冠心病 急性心肌梗死 心力衰竭 

分 类 号：R54[医药卫生—心血管疾病]