血清生长分化因子-15与急性冠状动脉综合征的相关性分析

目的：观察急性冠状动脉综合征患者血清中生长分化因子-15（growth differentiation factor-15，GDF-15）的水平与患者年龄、病史及相关实验室检查结果之间的关联性，探讨其产生的可能机制。 方法：采用前瞻性研究方法，入选进行冠状动脉造影检查的患者120例为研究对象，包括急性冠状动脉综合征组90例（急性心肌梗死早期组、急性心肌梗死7~14 d组和不稳定型心绞痛组各30例）和对照组30例。采用酶联免疫吸附法测定患者血清GDF-15浓度，采用logistic回归分析多因素与GDF-15水平之间的关联性。 结果：急性冠状动脉综合征组GDF-15水平［（649.0±224.21）ng/L］显著高于对照组［（537.2±262.9）ng/L，P<0.01］，其中，急性心肌梗死早期组GDF-15水平［（801.6±218.4）ng/L］显著高于急性心肌梗死7~14 d组［(656.2±252.4)ng/L,P<0.05，95% CI 1.001~1.061］、不稳定型心绞痛组［(586.9±225.6)ng/L,P<0.01，95% CI 0.809~0.950］和对照组（P<0.05，95% CI 1.000~1.012）。多元logistic回归筛选与GDF-15水平产生相关的因素为患者白细胞计数（r² =0.276，P<0.01）、乳酸脱氢酶（r² = 0.288，P<0.01）、肌酸激酶MB同工酶（r² = 0.350，P<0.01）和肌钙蛋白T（r²=0.344，P<0.01）均具有相关性。 结论：急性冠状动脉综合征患者血清GDF-15水平显著高于冠状动脉造影正常者，急性心肌梗死早期升高更明显，其水平与肌酸激酶MB同工酶、肌钙蛋白T、乳酸脱氢酶和白细胞等生物学标志物相关，提示GDF-15可能是一个新的心血管疾病生物标志物。

Correlation between levels of serum growth differentiation factor-15 and acute coronary syndrome

Objective:To explore the association between the levels of serum growth differentiation factor-15(GDF-15) and acute coronary syndrome(ACS) in patients undergoing coronary angiography(CAG).Methods: In this prospective study,120 candidates(30 healthy controls and 90 patients with ACS)admitted to our hospital from March 2006 to April 2008 were included.The patients with ACS were divided into 3 groups:(1)Group AMI-emergency(AMI-E),including 30 patients with acute myocardial infarction(AMI)who underwent CAG with...