白细胞介素-1β对急性心肌梗死患者全因死亡事件的预测价值

Predictive effect of interleukin-1β on all-cause mortality in patients with acute myocardial infarction

    摘要
  • 摘要:
    目的  评估白细胞介素-1β（IL-1β）对急性心肌梗死（AMI）患者全因死亡事件的预测价值。
    方法  对2022年9月至2024年10月间因AMI入住福建医科大学附属闽东医院胸痛中心的331例患者进行回顾性分析。根据血清IL-1β的四分位数将患者分为四组。采用Cox回归分析、Kaplan-Meier法、限制性立方样条（RCS）分析以及受试者操作特征（ROC）曲线分析检验IL-1β与全因死亡事件之间的相关性。
    结果  中位随访13个月后，有24例（7.3%）患者因各种原因死亡。在IL-1β第1、2、3、4四分位组中分别有 3（3.7%）、2（2.4%）、3（3.6%）和 16例（19.5%）死亡。Kaplan-Meier分析显示，与第1、2、3四分位组相比，第4四分位组患者的全因死亡事件增加（log-rank检验 P=0.003）。多变量Cox回归分析结果显示，调整协变量后，与IL-1β第1四分位组比较，第4四分位组患者发生全因死亡的风险增加（HR=5.82，95%CI 1.45～23.30；P=0.013）。RCS分析显示，IL-1β与全因死亡事件呈线性相关（P总体＜0.001，P非线性=0.421）。ROC曲线分析表明，IL-1β预测全因死亡事件的曲线下面积（AUC）为 0.774（95%CI 0.626～0.881），灵敏度为63.6%，特异度为91.2%。
    结论  IL-1β与AMI患者全因死亡事件相关；IL-1β可预测AMI患者的全因死亡风险。

     

    Abstract:
    Objective  To evaluate the predictive effect of interleukin-1β (IL-1β) on all-cause mortality in patients with acute myocardial infarction (AMI).
    Methods A total of 331 patients admitted to Chest Pain Center of Mindong Hospital Affiliated to Fujian Medical University for AMI from September 2022 to October 2024 were analyzed retrospectively. The patients were classified into four groups according to the quartile of the serum IL-1β. Cox regression analysis, Kaplan-Meier method, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis were used to examine the correlation between IL-1β and the risk of all-cause mortality.
    Results After a median follow-up of 13 months, 24 (7.3%) individuals experienced all-cause mortality. There were 3 (3.7%), 2 (2.4%), 3 (3.6%) and 16 (19.5%) deaths in the 1st, 2nd, 3rd and 4th quartile group respectively. Kaplan-Meier analysis showed that compared with the 1st, 2nd and 3rd quartile groups, the number of all-cause mortality in the 4th quartile group increased (log-rank test P=0.003). Multivariate Cox regression analysis showed that after adjusted for other factors, compared to the patients in the 1st quartile group, the patients in the 4th quartile group were at the highest risk of all-cause mortality (HR=5.82; 95%CI 1.45–23.30; P=0.013). RCS analysis showed that IL-1β was linearly associated with all-course mortality risk (Poverall＜0.001, Pnonlinear=0.421). ROC curve analysis demonstrated that the area under the curve (AUC) of IL-1β for prediction of all-cause mortality was 0.774 (95%CI 0.626–0.881), with a sensitivity of 63.6% and a specificity of 91.2%.
    Conclusions IL-1β is significantly associated with an increased risk of all-cause mortality in patients with AMI. IL-1β can predict the risk of all-cause mortality in patients with AMI.

     

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