GDF-15与心肌梗死后心室重塑指标的相关性分析

目的：探讨心肌梗死后心力衰竭患者血清生长分化因子-15（GDF-15）水平的变化，及与心功能和心肌纤维化指标的相关性。方法：人选急性心肌梗死后心力衰竭患者100例为心衰组，健康体检者50例为健康对照组。检测并分析两组患者GDF-15水平的变化，及其与心功能左心室收缩期内径（LVESd）、舒张末期内径（LVEDd）、左室射血分数（LVEF）]和心肌纤维化相关指标脑钠肽（BNP）、血清转化生长因子（TGFp、I型前胶原氨基端肽（PINP）和Ⅲ型前胶原氨基端肽（PIIINP）]的相关性。结果：与健康对照组相比，心衰组血清GDF-15（623．56±70．21）ng／L比（2003．53±163．2）ng／L]、TGFβ（21．5±6．80）ng／ml比（58．93±12．81）ng／ml]、PINP（150．58±32．57）ng／ml比（233．15±26．94）ng／ml]和PIIINP（17．56±8．72）ng／ml比（48．64±9．28）ng／ml]明显升高（P〈0．05~〈0．01）。随着心功能分级的增加（Ⅱ-Ⅳ），GDF-15的水平明显升高（1521．32±98．23）ng／L比（2311．92±108．52）ng／L比（3023．54±129．36）ng／L，P均〈O．01]。Pearson相关分析结果显示，心肌梗死后心力衰竭患者血清GDF-15水平与LVEF呈负相关（r=-0．574，P〈O．05），与LVESd和LVEDd呈正相关（r=0．688，0．752，P均〈0．05）；GDF-15水平与血浆BNP，血清PINP、PIIINP和TGFβ水平呈正相关（r=0．568～0．82，P均〈0．05）。结论：生长分化因子-15参与心肌梗死后心力衰竭患者的心室重塑。

Correlation analysis between growth differentiation factor-15 and ventricular remodeling indexes after myocardial infarction

Objective：To explore change of serum level of growth differentiation factor-15 （GDF-15） in patients with heart failure （HF） after myocardial infarction, and its correlation with cardiac function and myocardial fibrosis indexes. Methods： A total of 100 HF patients after acute myocardial infarction （AMI） were enrolled as HF group, and 50 healthy subjects were selected as healthy control group. GDF-15 level change was measured, its correlation with cardiac function left ventricular end-systolic diameter （LVESd）, left ventricular end-diastolic diameter （LVEDd） and left ventricular ejection fraction （LVEF）] and relative indexes of myocardial fibrosis brain natriuretic peptide （BNP）, serum transforming growth factor （TGFβ）, type I and III procollagen amino-terminal peptides （PINP, PIIINP）] were analyzed in two groups. Results： Compared with healthy control group, there were significant rise in serum levels of GDF-15 （623.56 ± 70. 21） ng/L vs. （2003.53 ± 163.2） ng/L], TGF~ （21.5± 6. 89） ng/ml vs. （58. 93 ± 12.81） ng/ml], PINP （150. 58± 32. 57） ng/ml vs. （233.15± 26.94） ng/ml] and PIIINP （17.56 ± 8. 72） ng/ml vs. （48. 64 ± 9.28） ng/ml] in HF group, P〈0.05~〈0. 01. Along with NYHA cardiac function class increased （Ⅱ-Ⅲ）, GDF-15 level significantly elevated （1521.32 ± 98. 23） ng/L vs. （2311.92 ±108.52） ng/L vs. （3023.54 ± 129. 36） ng/L, P〈0.01 all. Pearson correlation analysis indicated that in HF patients after myocardial infarction, serum GDF-15 level was inversely correlated with LVEF （r = - 0. 574, P〈0.05）, and positively correlated with LVESd and LVEDd （r = 0. 688,0. 752, P〈0.05 both） ; GDF-15 level was positively correla- ted with plasma BNP level, serum levels of PINP, PIIINP and TGFβ （r = 0. 568~0. 82, P〈0. 05 all）. Conclusion：Growth differentiation factor-15 is involved in ventricular remodeling in patients with heart failure after myocardial infarction.