生长分化因子15对慢性心力衰竭的诊断价值

目的探讨生长分化因子15（growth and differentiation factor 15,GDF15）对慢性心力衰竭（chronic heartfailure,CHF）的诊断价值。方法选择CHF患者80例,健康对照组30例,采用酶联免疫吸附法（ELISA）测定血清GDF15浓度,比较CHF组与健康对照组血清GDF15质量浓度的变化,分析GDF15与纽约心脏协会心功能分级之间的相关性。结果CHF组血清GDF15质量浓度明显高于对照组,差异有统计学意义（2 840.85±846.18）ng/Lvs.（807.33±355.56）ng/L,P〈0.05）。相关性分析显示GDF15与纽约心脏协会心功能分级存在显著的正相关（r=0.840,P=0.000）,GDF15随纽约心功能分级的增高而升高。方差分析显示,心功能I级、Ⅱ级、Ⅲ级、Ⅳ级患者间的血清GDF15质量浓度比较,差异有统计学意义（P〈0.05）。受试者工作特征曲线显示CHF组GDF15曲线下面积为0.902,P=0.0001,若取血清GDF15质量浓度为1 105.50 ng/L,其诊断CHF的敏感性为85.0%,特异性为76.7%。结论 GDF15可能作为CHF患者一个新的生物标志物,可以客观评价CHF的严重程度。

Assessment of growth and differentiation factor 15 for diagnosis of chronic heart failure

Objectives To explore assessment of growth and differentiation factor 15(GDF15) for diagnosis of chronic heart failure(CHF).Methods Eighty patients with CHF and 30 normal controls were selected in this study.Serum concentrations of GDF15 in CHF group and control group were measured by enzyme-linked immunosorbent assay ELISA and compared.Correlation between GDF15 and New York Heart Associtation(NYHA) functional classification was analyzed.Results Serum concentration of GDF15 in CHF group was significantly higher than that in control group (2 840.85±846.18) ng/L vs.(807.33±355.56)ng/L,P<0.05].Analysis showed serum concentration of GDF15 was positively correlated with NYHA functional classification(r=0.840,P=0.000).Serum concentration of GDF15 increased with the worsening of cardiac function.ANOVA analysis showed that serum concentrations of GDF15 among patients in NYHA functional class Ⅰ,Ⅱ,Ⅲ,Ⅳ were significantly different(P<0.05).Area under receiver operating characteristic curve for GDF15 serum concentration in CHF group was 0.902(P=0.0001).When serum concentration of GDF15 was 1 105.50 ng/L,sensitivity for CHF diagnosis CHF was 85.0%,and the specificity was 76.7%.Conclusions GDF15 could be a new biomarker in patients with CHF to evaluate the severity of chronic heart failure objectively.