培哚普利对慢性心力衰竭患者血清生长分化因子15水平的影响

目的研究培哚普利对慢性心力衰竭(心衰)患者血清生长分化因子15(GDF-15)水平的影响及与病情的相关性。方法将79例慢性心衰(心衰组)患者随机再分为2组:小剂量组39例,大剂量组40例,疗程6个月。另选择40例仅有心血管病危险因素的患者作为对照组。ELISA法检测2组治疗前后GDF-15、N末端B型钠尿肽前体(NT-proBNP)水平;分析GDF-15与NT-proBNP、纽约心功能分级(NYHA)、超声心动图指标的相关性。结果心衰组GDF-15、NT-proBNP水平明显高于对照组(P<0.01)。NYHAⅠ～Ⅳ级患者GDF-15、NT-proBNP水平随NYHA逐级递增(P<0.01)。GDF-15分别与NT-proBNP(r=0.903,P=0.000)、NYHA(r=0.636,P=0.000)、左心室舒张末内经(r=0.806,P=0.000)呈正相关,与LVEF(r=-0.704,P=0.000)呈负相关。治疗6个月后,小剂量组与大剂量组GDF-15、NT-proBNP水平较治疗前明显降低(P<0.01),大剂量组较小剂量组降低更明显(P<0.01)。结论 GDF-15可作为新的心衰标记物,有助于评估疗效和预后。

Effect of perindopril on serum GDF-15 level in chronic heart failure patients

Objective To study the correlation between the effect of perindopril on serum GDF-15 level in chronic heart failure(CHF) patients and the condition of CHF patients.Methods Seventy -nine CHF patients were randomly divided into low perindopril(LP) group(n=39) and high perindopril(HP) group(n = 40),and 40 patients with risk factors for cardiovascular disease served as a control group.Patients in LP group received perindopril(4 mg/d) plus routine anti-hear failure treatment and those in HP group received perindopril(8—10 mg/d) plus routine anti-heart failure treatment for 6 months.Their serum GDF-15 and NT-proBNP levels were measured by ELISA before and after treatment.Correlation of GDF-15 level with NT-proBNP,NYHA classification and echocardiographic parameters was analyzed.Results The GDF-15 and NT-proBNP levels were significantly higher in heart failure group than in control group and increased with the NYHA classification inⅠ-ⅣNYHA CHF patients(P<0.01).The GDF-15 level was positively related with NT-proBNP(r=0.903),NYHA classification(r = 0.636),LVEDD(r=0.806) and negatively related with LVEF(r=—0.704).The GDF-15 and NT-proBNP levels were significantly lower in LP and HP groups,especially in HP group than in LP group,6 months after treatment than before treatment(P<0.01).Conclusion GDF-15 can be used as a novel marker for heart failure and contributes to the assessment of the therapeutic effect of perindopril and the prognosis of CHF patients.