GDF15、BNP在慢性心力衰竭患者血清中的表达及临床意义

目的:探讨慢性心力衰竭患者血清生长分化因子15(growth differentiation factor 15,GDF15)水平与NYHA心功能分级、血浆脑钠肽(brain natriuretic peptide,BNP)相关性及临床意义.方法:慢性心力衰竭患者80例,对照组30例,采用酶联免疫吸附法(ELISA)测定血清GDF15水平,微粒子酶免疫分析(MEIA)检测血浆BNP水平,NYHA心功能分级标准对慢性心力衰竭组进行分级.比较慢性心力衰竭组与对照组血清GDF15浓度的变化,分析GDF15与BNP的相关性,了解GDF15与NYHA心功能分级之间的相关性.结果:慢性心力衰竭组血清GDF15水平(2840.85±846.18 ng/l)和对照组(807.33±355.56 ng/l)比较,差异有统计学意义(P＜0.01);NYHA心功能分级不同亚组GDF15水平具有明显差别(P＜0.01).慢性心力衰竭组血清GDF15与血浆BNP水平呈显著正相关(r=0.798,P＜0.05),GDF15水平随BNP水平的升高而升高;与NYHA心功能分级正相关(r=0.840,P=0.000),随NYHA心功能分级的增高而升高.结论:血清GDF15可能作为慢性心力衰竭患者一个新的生物标志物,可以客观评价心力衰竭的严重程度,预测患者的活动耐量.血清GDF15浓度与血浆BNP、NYHA心功能分级呈正相关,为综合评价心力衰竭患者心功能状态提供了一个新的思路.

Correlation between Serum Levels of Growth Differentiation Factor 15 and Cardiac Function in Patients with Chronic Heart Failure

Objective：To explore serum concentrations of growth differentiation factor 15 （GDF15） in patients with chronic heart failure （CI4F） and the relationship between GDF15 and cardiac function classifica tion, BNP. Methods：Eighty patients with CHF and 30 normal controls were selected in this study, The serum level of GDF15 and the palsma level of BNP were measured by sandwich ELISA and MEIA method in all sub jects respectively,New York Heart Association （NYHA） functional classifications. Serum GDF15 levels in CHF group and control group were compared , the correlation between GDFI5 and BNP was analyzed, the correlation between GDF15 and the NYHA functional classification was studied . Results： The serum level of GDF15 （2 840.85 ±846.18 ng/1） in CHF group and each subgroups according to NYHA functional class were all signifi cantly higher than that in control group （807.33 ±355.56 ng/1）, a value of P 〈 0.01. There were significantly positive correlations between GDF15 and BNP in patients with CHF （r = 0.798,P 〈 0.05）, the serum level of GDF15 increased as well as plasma BNP level increased. There were positive correlation between GDF15 and NYHA functional classification （r = 0. 840 ,P = 0. 000）, and serum GDF15 level increased with the worsening of cardiac function. Conclusions：GDFl5 may be used as a new biomarker in patients with CHF and evaluate the severity of heart failure objectively and predict activity tolerance in patients. GDF15 has significantly positive correlations with BNP and NHYA functional classification. GDF15 provides a new way of thinking for us to eval uate cardiac function in patients with heart failure comprehensively.