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南京医科大学学报(自然科学版) 第43卷第1期
· 40 · Journal of Nanjing Medical University(Natural Sciences) 2023年1月
·临床研究·
先天性心脏病相关肺动脉高压血清IL⁃32的变化与肺动脉压相
关性研究
花 颖 ,刘文世 ,郑冬冬 ,张 伟 ,黄 荣 ,李晓飞 1*
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南通大学附属医院心血管内科,江苏 南通 226001;厦门市第五医院心血管内科,福建 厦门 361101
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[摘 要] 目的:探讨血清白介素⁃32(interleukin⁃32,IL⁃32)水平与先天性心脏病相关肺动脉高压(pulmonary arterial hypertension,
PAH)的存在和严重程度之间的关系。方法:试验组纳入 85 例 CHD 患者,根据右心导管术测得的平均肺动脉压
(mean pulmonary artery pressure,PAPm)将其分为:无 PAH 组(PAPm≤20 mmHg)、灰色区间组(20 mmHg<PAPm<25 mmHg)、轻
度组(25 mmHg≤PAPm<35 mmHg)、中重度组(PAPm≥35 mmHg),对照组为 30 例健康成人。采用酶联免疫吸附试验检测各
组血清 IL⁃32 的水平,化学发光微粒子免疫分析法用于测定实验组血浆 B 型脑钠肽(B⁃type natriuretic peptide,BNP)的水平。
结果:中重度组、轻度组和灰色区间组的血清IL⁃32水平显著高于无PAH组及对照组,肺体循环血流量比(Qp/Qs)≥1.5的CHD
患者血清 IL⁃32 水平显著高于 Qp/Qs < 1.5 的 CHD 患者。血清 IL⁃32 水平与 PAPm(r=0.377,P < 0.05)、肺动脉收缩压
(r=0.286,P < 0.05)及 Qp/Qs(r=0.266,P < 0.05)正相关。受试者工作特征(receiver operating characteristic,ROC)曲线分析
IL⁃32 诊断 PAH(PAPm > 20 mmHg)的效能不劣于 BNP,两者联合诊断具有更高的灵敏度、阳性预测值和阴性预测值。
结论:血清IL⁃32可能是先天性心脏病相关肺动脉高压的潜在生物标志物。
[关键词] 先天性心脏病;肺动脉高压;白介素⁃32;循环标志物
[中图分类号] R541.1 [文献标志码] A [文章编号] 1007⁃4368(2023)01⁃040⁃06
doi:10.7655/NYDXBNS20230106
Correlation between serum IL⁃32 and pulmonary artery pressure in congenital heart disease
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HUA Ying ,LIU Wenshi ,ZHENG Dongdong ,ZHANG Wei ,HUANG Rong ,LI Xiaofei 1*
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Department of Cardiology,Affiliated Hospital of Nantong University,Nantong 226001;Department of Cardiology,
the Fifth Hospital of Xiamen,Xiamen 361101,China
[Abstract] Objective:To explore the correlation between serum interleukin ⁃ 32(IL ⁃ 32)level and the presence and severity of
pulmonary arterial hypertension(PAH)associated with congenital heart disease(CHD). Methods:Eighty ⁃ five CHD patients were
enrolled in the experimental group,and these patients were divided into the non⁃PAH group(PAPm≤20 mmHg),grey area group
(20 mmHg<PAPm<25 mmHg),mild group(25 mmHg≤PAPm<35 mmHg),and moderate⁃severe group(PAPm≥35 mmHg)by mean
pulmonary artery pressure(PAPm)measured using right heart catheterization;the control group consisted of 30 healthy adults.
Enzyme ⁃ linked immunosorbent assay(ELISA)was used to measure serum IL ⁃ 32 level in various groups,and chemiluminescent
microparticle immunoassay(CMIA)was used to measure the plasma B⁃type natriuretic peptide(BNP)level in the experimental group.
Results:Serum IL⁃32 levels in the moderate⁃severe,mild,and grey area groups were significantly higher than those in the non⁃PAH
and control groups. The serum IL ⁃ 32 level in CHD(Qp/Qs≥1.5)patients was significantly higher than that in CHD(Qp/Qs<1.5)
patients. The serum IL⁃32 level was positively correlated with PAPm(r=0.377,P < 0.05),pulmonary artery systolic pressure(r=0.286,
P < 0.05),and Qp/Qs(r=0.266,P < 0.05). Receiver operating characteristic(ROC)curve analysis found that the performance of IL⁃32
in the diagnosis of PAH(PAPm>20 mmHg)was non⁃inferior to BNP,and diagnosis using the combined IL⁃32 and BNP had higher
sensitivity,positive predictive value,and negative predictive value. Conclusion:Serum IL⁃32 may be a biomarker for PAH associated
with CHD.
[Key words] congenital heart disease;pulmonary arterial hypertension;interleukin⁃32;circulating marker
[J Nanjing Med Univ,2023,43(01):040⁃045]
[基金项目] 南通市科技计划项目(JCZ19107)
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通信作者(Corresponding author),E⁃mail:sofia_l@163.com