血浆生长分化因子-15水平检测对左心衰竭的临床意义

目的:通过检测生长分化因子-15(GDF-15)血浆水平来探讨其与左侧心力衰竭(心衰)的关系,并与脑钠肽(BNP)比较其在左心衰诊断中的价值。方法:入选左心衰患者110例和正常人36例。ELISA检测血浆GDF-15水平。结果:左心衰组血浆GDF-15水平较对照组明显升高2 368.65(1 493.96,3 859.89)ng/L∶1 090.80(892.59,1 749.35)ng/L,P<0.01],且随着NYHA程度的加重而增加。相关分析显示,GDF-15分别与NYHA分级(r=0.567,P=0.00)、左室舒张末径(r=0.209,P=0.030)、左室射血分数(r=-0.226,P=0.019)、BNP(r=0.223,P=0.020)有相关性。多元线性回归分析中,仅有NYHA分级(标化的相关系数B=0.576,P=0.000)与GDF-15密切相关。ROC曲线分析表明,GDF-15与BNP均可用于诊断慢性心衰。结论:GDF-15是良好心衰标志物,可作为辅助诊断左心衰的指标。

Clinical significance of plasma growth differentiation factor-15 in patients with left heart failure

Objective:Through assessing relationship between plasma GDF-15 levels and left heart failure(HF),to explore the diagnosis value of plasma GDF-15 in HF patients.Method:There were 110 patients with HF and 36 normal controls were recruited for this study.Based on causes,they were classified as ischemic heart failure group(IHF,n=69) and non-ischemic heart failure group(NIHF,n=41);Further,based on left ventricular ejection function,they were divided into heart failure with the left ventricular ejection fraction(LVEF) ≤45%(n=29) and heart failure with the LVEF>45%(n=81).GDF-15 levels were measured by ELISA.Result:Plasma concentration of GDF-15 was significantly higher in HF group than in control 2 368.65(1 493.96,3 859.89)ng/L∶1 090.80(892.59,1 749.35)ng/L,P<0.01],and it was gradually increased depending on NYHA functional class.Multivariate stepwise regression analysis showed that only NYHA classification(B=0.576,P=0.000) has close relationship with GDF-15.Further,ROC curves analysis showed that both GDF-15 and BNF could be used for HF diagnosis.Conclusion:Compare with BNP,GDF-15 may serve as a good biomarker for the diagnosis of HF.