心房颤动患者血清生长分化因子-15检测及其临床意义

【摘要】目的 观察血清中生长分化因子-15（GDF-15）在心房颤动（房颤）患者中的水平。方法 连续入选2012年8月-2013年6月于心脏科住院的非瓣膜性房颤患者104例，其中阵发性房颤67例（阵发房颤组），持续性房颤37例（持续房颤组）；收集同期年龄、性别及动脉粥样硬化危险因素相匹配的非房颤患者67例作为对照组。采用酶联免疫吸附法测定血清中GDF-15含量，比较各组心脏超声及实验室检查指标水平，分析GDF-15与超敏C反应蛋白（hs-CRP）相关性以及导致房颤发生的影响因素。结果 各组间年龄、高血压史、冠心病史、脑卒中史等基线资料差异均无统计学意义。多组间比较发现，GDF-15只有在阵发性房颤组与对照组中差异有统计学意义[(1473.14±628.52)μg/Lvs(1233.592±262.76)μg/L,P=0.012]。GDF-15与hs-CRP呈正相关（rs=0.172，P=0.044）。Logistic回归分析显示GDF-15升高是发生阵发性房颤或房颤的危险因素（OR:1.002，95%CI:1.000~1.003，P<0.05)。结论 房颤患者GDF-15水平明显高于对照组，GDF-15升高是阵发性房颤或房颤的危险因素。

Examining Circulating Growth Differentiation Factor-15Levels and Its Clinical Significance in Patients with Non-Valvular Atrial Fibrillation

[Abstract] Objective To investigate circulating level of growth differentiation factor-15(GDF-15) in patients withnon-valvular atrial fibrillation (AF).Methods We enrolled104consecutive patients with AF (67are paroxymal AF and37 are persistent AF) that presented to our hospital between August2012and June2013. Subjects without AF (n=67) was used as controls who were matched for sex, age and atherosclerotic risk factors enrolled in the same period. Serum GDF-15con?centration was detected byenzymelinked immunosorbent assay(ELISA). Echocardiography and laboratory parameters were compared among three groups. The correlation of GDF -15and hypersensitive c-reactive protein (hs-CRP) as well as the risk factors of development of AF were also analyzed.Results No significant difference in age, history of hypertension, coro?nary heart disease, and stroke was found among three groups (P>0.05). GDF-15had significant difference between pa?ients with paroxysmal AF and controls [(1473.14±628.52)μg/Lv (1233.592±262.76)μg/L,P=0.012]. GDF-15level was correlated with hs-CRP (rs=0.172，P=0.044). Multivariable analysis demonstrated that high GDF-15is a risk factor of devel?opment of paroxysmal AF/AF (OR: 1.002, 95%CI: 1.000-1.003, P<0.05).Conclusion Patients with AF have a higher se?rum level of GDF-15compared with controls and GDF-15level is a risk factor of development of paroxysmal AF/AF.