白介素18、白介素10及左房存储 应变与心房颤动患者射频消融 术后复发的相关性

Correlation between Interleukin-18, Interleukin-10, Left Atrial Storage Strain and Recurrence after Radiofrequency Ablation in Patients with Atrial Fibrillation

摘要: 目的：分析白细胞介素18 (IL-18)、白细胞介素10 (IL-10)及左房存储应变(LASr)与心房颤动(房颤)患者射频消融术后复发的相关性，为临床预测复发风险提供参考。方法：连续选取2023年1月至2025年8月包头市中心医院心血管内科住院患者180例，分为三组各60例，即阵发性房颤(PAF)组、持续性房颤(PsAF)组及健康对照组。所有研究对象入院后采集外周静脉血，行LASr检查；房颤患者行射频消融术后4个月再次行上述检查。将采集的静脉血采用ELISA法检测血清IL-18、IL-10浓度，测量LASr的数据进行记录。通过心电图明确房颤患者术后复发情况，分析三者与术后复发的相关性。结果：三组研究对象血清IL-18、IL-10浓度及LASr水平均存在显著差异(P < 0.05)；其中，IL-10、LASr水平呈PsAF组 < PAF组 < 健康对照组，IL-18水平呈PsAF组 > PAF组 > 健康对照组，组间两两比较差异均有统计学意义(P < 0.05)。120例房颤患者术后3个月内复发47例，总复发率39.17%，PsAF组复发率(48.33%)高于PAF组(30.00%)，复发率比较差异有统计学意义(P < 0.05)。复发组IL-18显著高于未复发组，IL-10及LASr显著低于未复发组，差异有统计学意义(P < 0.001)。单因素Logistic回归分析显示，IL-18升高、IL-10降低、LA Sr降低与术后复发有潜在关联(P < 0.001)。多因素Logistic回归分析显示，高IL-18、低IL-10、低LASr是术后复发的独立危险因素(P < 0.05)；ROC曲线分析显示，IL-10、IL-18、LASr单独检测AUC分别为0.861、0.832、0.834，联合检测AUC为0.890，均有统计学意义(P < 0.001)。结论：IL-18、IL-10及LASr可作为评估房颤患者射频消融术后复发的预测指标。

Abstract: Objective: To analyze the correlation between interleukin-18 (IL-18), interleukin-10 (IL-10), left atrial storage strain (LASr) and recurrence after radiofrequency ablation in patients with atrial fibrillation (AF), so as to provide reference for clinical prediction of recurrence risk. Methods: A total of 180 inpatients in the Department of Cardiovascular Medicine, Baotou Central Hospital from January 2023 to August 2025 were consecutively enrolled and divided into three groups (n = 60 each): paroxysmal atrial fibrillation (PAF) group, persistent atrial fibrillation (PsAF) group, and healthy control group. Peripheral venous blood samples were collected and left atrial strain rate (LASr) examination was performed in all subjects after admission. The above examinations were repeated in atrial fibrillation patients at 4 months after radiofrequency catheter ablation. Serum concentrations of interleukin‑18 (IL‑18) and interleukin‑10 (IL‑10) were measured by enzyme‑linked immunosorbent assay (ELISA), and LASr data were recorded. Postoperative recurrence of atrial fibrillation was confirmed by electrocardiography, and the correlation between IL‑18, IL‑10, LASr and postoperative recurrence was analyzed. Results: There were significant differences in serum IL-18, IL-10 concentrations and LASr levels among the three groups (P < 0.05); among them, the levels of IL-10 and LASr were in the order of PsAF group < PAF group < healthy control group, while the level of IL-18 was in the order of PsAF group > PAF group > healthy control group, with significant differences between groups (P < 0.05). A total of 47 out of 120 AF patients had recurrence within 3 months after operation, with a total recurrence rate of 39.17%; the recurrence rate of PsAF group (48.33%) was higher than that of PAF group (30.00%), and the difference was statistically significant (P < 0.05). The level of IL-18 in the recurrence group was significantly higher than that in the non-recurrence group, while the levels of IL-10 and LASr were significantly lower than those in the non-recurrence group (P < 0.001). Univariate Logistic regression analysis showed that elevated IL-18, decreased IL-10 and decreased LASr were potentially associated with postoperative recurrence (P < 0.001). Multivariate Logistic regression analysis showed that high IL-18, low IL-10 and low LASr were independent risk factors for postoperative recurrence (P < 0.05); ROC curve analysis showed that the AUCs of IL-10, IL-18 and LASr alone in predicting postoperative recurrence were 0.861, 0.832 and 0.834, respectively, and the AUC of combined detection was 0.890, all with statistical significance (P < 0.001). Conclusion: IL-18, IL-10 and LASr can be used as predictive indicators for evaluating the recurrence of AF patients after radiofrequency ablation.