血浆IL-23、IL-38水平与急性心肌梗死诊断及预后的相关性

The Correlation between Plasma IL-23 and IL-38 Levels and the Diagnosis and Prognosis of Acute Myocardial Infarction

摘要: 目的：探讨血浆白细胞介素-23 (interleukin-23, IL-23)、白细胞介素-38 (interleukin-38, IL-38)在急性心肌梗死(Acute Myocardial Infarction, AMI)发病中的表达、作用，及二者作为AMI诊断与预后指标的价值。方法：选取2025年1月至2025年4月于包头市中心医院就诊的67例AMI患者作为AMI组，同期45例健康体检者作为对照组。比较两组血浆IL-23、IL-38水平差异；采用受试者工作特征(Receiver Operating Characteristic, ROC)曲线分析二者对AMI的潜在辅助诊断价值，半年后电话随访AMI患者预后情况，分析IL-23、IL-38与主要不良心血管事件(Major Adverse Cardiovascular Events, MACE)发生的相关性及预测价值。结果：AMI组血浆IL-23、IL-38水平均显著高于对照组(均P < 0.05)；多因素Logistic回归显示，IL-38是AMI的独立影响因素(OR = 1.020, 95% CI: 1.013~1.028, P < 0.001)，IL-23无统计学意义(OR = 1.004, 95% CI: 0.998~1.010, P = 0.184)。随访期间，13例AMI患者发生MACE，其IL-23、IL-38水平显著高于未发生MACE者(P < 0.05)；多因素Logistic回归显示，IL-23 (OR = 1.022, 95% CI: 1.000~1.044, P = 0.046)、IL-38 (OR = 1.050, 95% CI: 1.005~1.097, P = 0.027)均是AMI的独立影响因素。二者联合检测预测MACE的AUC = 0.877，预测效能最优。结论：血浆IL-38水平与AMI辅助诊断密切相关，IL-23与IL-38联合检测在AMI的短期预后评估中具有重要临床应用价值。

Abstract: Objective: To explore the expression and role of plasma interleukin-23 (IL-23) and interleukin-38 (IL-38) in the pathogenesis of acute myocardial infarction (AMI), as well as their value as diagnostic and prognostic indicators for AMI. Methods: Sixty-seven patients with AMI who visited Baotou Central Hospital from January 2025 to April 2025 were selected as the AMI group, while 45 healthy individuals undergoing physical examinations during the same period were selected as the control group. The differences in plasma IL-23 and IL-38 levels between the two groups were compared. The potential auxiliary diagnostic value of these two indicators for AMI was analyzed using the receiver operating characteristic (ROC) curve. After half a year, the prognosis of the AMI patients was followed up by phone, and the correlation and predictive value of IL-23 and IL-38 with major adverse cardiovascular events (MACE) were analyzed. Results: The levels of plasma IL-23 and IL-38 in the AMI group were significantly higher than those in the control group (both P < 0.05); multivariate Logistic regression analysis showed that IL-38 was an independent influencing factor for AMI (OR = 1.020, 95% CI: 1.013~1.028, P < 0.001), while IL-23 had no statistical significance (OR = 1.004, 95% CI: 0.998~1.010, P = 0.184). During the follow-up period, 13 AMI patients developed MACE, and their levels of IL-23 and IL-38 were significantly higher than those who did not develop MACE (P < 0.05); multivariate Logistic regression analysis showed that IL-23 (OR = 1.022, 95% CI: 1.000~1.044, P = 0.046) and IL-38 (OR = 1.050, 95% CI: 1.005~1.097, P = 0.027) were both independent influencing factors for AMI. The combined detection of IL-23 and IL-38 had an AUC of 0.877 for predicting MACE, with the optimal predictive efficacy. Conclusion: The level of plasma IL-38 is closely related to the auxiliary diagnosis of AMI. The combined detection of IL-23 and IL-38 has significant clinical application value in the short-term prognosis assessment of AMI.