血清IL-33/sST2比值对维持性血液透析患者心力衰竭的预警价值OA

Objective To investigate the early warning value of serum interleukin-33(IL-33)/soluble ST2(sST2)ratio for heart failure(HF)in patients undergoing maintenance hemodialysis(MHD).Methods The clinical data of 129 MHD patients hospitalized in Tangshan Hongci Hospital from January 2022 to July 2024 were selected,and divided into HF group(n=48)and non-HF group(n=81)according to whether HF occurred.The clinical data,serum IL-33,sST2 levels and IL-33/sST2 ratio were compared between the two groups.Lasso-Logistic regression was used to analyze the influencing factors of HF in patients undergoing MHD.The receiver operating characteristic(ROC)curve was used to evaluate the early warning value of serum IL-33/sST2 ratio for HF in patients undergoing MHD.Results The dialysis age,levels of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the HF group were higher than those in the non-HF group,and the left ventricular ejection fraction(LVEF)was lower than that in the non-HF group(P＜0.01).The levels of serum IL-33,sST2 and IL-33/sST2 ratio in HF group were significantly higher than those in non-HF group(P＜0.01).Multivariate logistic regression analysis showed that IL-8,NT-proBNP and IL-33/sST2 ratio were independent risk factors for HF in MHD patients(P＜0.05,P＜0.01).The ROC curve showed that the IL-33/sST2 ratio had a high predictive value for predicting HF in patients undergoing MHD,with an area under the curve(AUC)of 0.869(95％CI:0.798,0.922).When the optimal cut-off value was 7.64,the sensitivity and specificity of the prediction reached 79.17％and 88.89％,respectively,and the Youden index was 0.681.Delong test showed that the AUC values of IL-8(0.733)and NT-proBNP(0.766)were significantly lower than those of IL-33/sST2 ratio(P＜0.05).Conclusion The serum IL-33/sST2 ratio is an independent risk factor for HF in patients undergoing MHD.Its predictive efficacy is significantly better than IL-8 and NT-proBNP.