哈萨克族心力衰竭患者血浆生长分化因子15和B型利钠肽的临床意义

Clinical significance of Plasma growth differentiation factor 15 and B-type natriuretic peptide in patients with heart failure in Xinjiang Kazakans in China

目的:研究血浆生长分化因子15(GDF-15)、B型利钠肽(BNP)对新疆哈萨克族(哈族)心力衰竭(HF)的意义及与其严重程度之间的关系。方法:选取新疆哈族HF患者90例(NYHAⅡ～IV级)及哈族NYHAⅠ级患者30例为研究对象,均采取空腹静脉血,测定血浆BNP及GDF-15水平,同时超声心动图测定各项心功能指标。结果:哈族HF组患者血浆GDF-15和BNP水平明显高于对照组[GDF-15(132.14±56.36)ng/L∶(34.08±10.80)ng/L;BNP(273.78±93.37)ng/ml∶(82.80±15.18)ng/ml,P<0.01],并随NYHA心功能分级的增加而升高,各组间差异均有统计学意义(均P<0.01)。哈族HF患者血浆GDF-15水平与血肌酐(Cr)、左心房前后径(LAD)、左心室舒张末期内径(LVEDd)、NYHA、BNP呈正相关(r=0.266、0.423、0.668、0.925、0.845,P<0.05);与左心室射血分数(LVEF)、左心室短轴缩短率(FS)呈显著负相关(r=-0.807、-0.733,P<0.01)。结论:哈族HF患者血浆GDF-15、BNP水平明显升高,与哈族HF程度密切相关,血浆GDF-15水平是判断哈族HF严重程度有价值的指标。

Objective：To study the significance of plasma growth differentiation factor 15（GDF-15）,B-type natriuretic peptide（BNP） in patients with heart failure（HF） in Xinjiang Kazakans,and its relationship with the severity of HF.Method：There were 90 Kazaks patients with HF（NYHA Ⅱ~Ⅳ class） and 30 Kazaks patients with NYHA Ⅰ level included in the study.Fasting venous blood were taken to measure plasma GDF-15 and BNP levels,while heart indicators of echocardiography were measured for comparison.Result：The plasma levels of GDF-15 and BNP in HF group were significantly higher than those in the control group;and increased with NYHA class increasing,with statistically significant difference（P0.01）.Plasma GDF-15 was positively correlated with Cr,LAD,LVEDd,NYHA class,BNP（r=0.266,0.423,0.668,0.925,0.845,P0.05）,and negatively correlated with LVEF,FS（r=-0.807,-0.733,P0.01）.Conclusion：The plasma GDF-15 and BNP levels are significantly higher in Kazaks patients with HF,and they are dependent on HF severity.Plasma GDF-15 level predicts the severity of Kazakh ethnic HF as a valuable indicator.