IL-6对住院心力衰竭患者发生心房颤动的预测价值

The Predictive Value of IL-6 in Atrial Fibrillation in Hospitalized Patients with Heart Failure

摘要: 目的：探讨白介素-6 (IL-6)水平对心力衰竭(HF)患者并发房颤的预测价值。方法：选取2021年9月~2023年8月期间青岛大学附属医院收治的120例心力衰竭患者。根据IL-6的三分位数，将患者分为三组，分析基线特征差异：组1 (0 < IL-6 < 4.69, n = 39)、组2 (4.69 ≤ IL-6 < 11.29, n = 40)、组3 (11.29 ≤ IL-6, n = 41)。进一步将患者分为房颤组(n = 38)和非房颤组(n = 82)，并采用logistic回归分析研究了这两组患者的人口学特征、血清生化指标以及心超相关指标，同时绘制受试者工作特征曲线(ROC)以分析其预测效能。结果：在120例心力衰竭患者中，基线特征显示三组患者在年龄、性别、收缩压、舒张压、心率、吸烟史、饮酒史、高血压病史、血运重建史、糖尿病病史、高脂血症病史以及心超指标以外的其他实验室指标方面均无显著性差异(P > 0.05)。三组之间在血钙水平测定结果方面存在显著差异(2.30 (2.16, 2.36) vs 2.21 (2.15, 2.26) vs 2.19 (2.05, 2.25) mmol/L, P = 0.026)。并发房颤的发生率为31.8%。单因素分析结果显示，年龄、心功能分级、高密度脂蛋白、IL-6和cTnI均为心力衰竭患者并发房颤的主要因素，其中心功能分级和IL-6是其独立危险因素(P< 0.05, OR > 1)。ROC曲线分析显示，IL-6预测心衰患者发生房颤的曲线下面积为0.6672 (95% CI 0.5599 to 0.7745, P < 0.05)，灵敏度为0.8293，特异度为0.5263，约登指数为0.3556，最佳截断值为Ln (IL-6) = 1.290。结论：本研究表明，IL-6水平与心力衰竭患者并发房颤密切相关，可作为指标因子用于预测心力衰竭患者发生房颤。

Abstract: Objectives: To assess the predictive value of interleukin-6 (IL-6) levels in heart failure (HF) patients with concomitant atrial fibrillation. Methods: We enrolled 120 HF patients admitted to the Affiliated Hospital of Qingdao University between September 2021 and August 2023. Patients were divided into three groups based on the IL-6 quantile and baseline differences in characteristics were ana-lyzed: Group 1 (0 < IL-6 < 4.69, n = 39), Group 2 (4.69 ≤ IL-6 < 11.29, n = 40), and Group 3 (11.29 ≤ IL-6, n = 41). Subsequently, the cohort was stratified into atrial fibrillation (AF) (n = 38) and non-AF (n = 82) groups. Logistic regression was employed to analyze demographic characteristics, serum biochemical markers, and echocardiographic parameters. Receiver operating characteristic curves (ROC) were constructed to evaluate predictive performance. Results: Among the 120 HF patients, baseline characteristics revealed no significant differences in age, sex, systolic and diastolic blood pressure, heart rate, smoking and drinking history, hypertension, revascularization, diabetes, hy-perlipidemia history, cardiac index, and other laboratory parameters among the three IL-6 groups (P > 0.05). Notably, blood calcium levels differed significantly among the three groups (2.30 (2.16, 2.36) vs 2.21 (2.15, 2.26) vs 2.19 (2.05, 2.25) mmol/L, P = 0.026). The incidence of AF was 31.8%. Univariate analysis identified age, cardiac function grade, high-density lipoprotein, IL-6, and cTnI as primary risk factors for AF in HF patients, with cardiac function grade and IL-6 emerging as inde-pendent risk factors (P < 0.05, OR > 1). ROC analysis demonstrated that IL-6 effectively predicted AF in HF patients, yielding an area under the curve of 0.6672 (95% CI 0.5599 to 0.7745, P < 0.05), sen-sitivity of 0.8293, specificity of 0.5263, and a Youden index of 0.3556. The optimal cutoff value was Ln (IL-6) = 1.290. Conclusions: IL-6 levels exhibit a strong association with AF in HF patients and can serve as a valuable predictor for AF occurrence.