高血压病患者血浆生长分化因子-15水平与左心室几何构型的关系

Relationship between plasma GDF-15 and left ventrieular geometry in essential hypertension

目的探讨高血压病患者左心室重构的不同阶段血浆生长分化因子-15（GDF-15）水平与左心室几何构型的关系。方法对61例血压达标的高血压病患者进行超声心动图检查，依据左心室质量指数（LVMI）、左心室相对室壁厚度将患者分为左心室正常构型组（n=13）、向心性重构组（n=15）、向心性肥厚组（n=18）和离心性肥厚组白=15）。20例健康体检者为对照。ELISA法测定血浆GDF-15水平。结果对照组、左心室正常构型组患者血浆GDF-15水平之间比较差异无统计学意义（228．69±113．45vs．233．32±87．62ng/L，P〉0．05）。与对照组比较，左心室向心性重构组010．81±95．48VS．228．69±113．45ng／L，P〈0．05）、向心性肥厚组（379．66±114．57vs．228．69±113．45ng／L，P〈0．01）和离心性肥厚组（474．80±85．14vs．228．69±113．45ng／L，P〈0．01）患者的血浆GDF-15水平显著升高。左心室向心性重构组患者血浆GDF水平显著高于正常构型组（310．81±95．48vs．233．32±87．62ng／L，P=0．048），但与向心性肥厚组比较差异无统计学意义（310．81±95．48vs．379．66±114．57，P=0．057）。左心室离心性肥厚组患者的血浆GDF-15水平显著高于向心性肥厚组（474．80±85．14vs379．66±114．57ng／L，P=0．009）。合并左心室肥厚的高血压患者血浆GDF-15水平与LVMI呈显著的正相关（P〈0．01）。结论在血压达标的高血压病患者，血浆GDF-15水平仍能很好的反映左心室肥厚的程度。

Objective To investigate the relationship between the levels of plasma growth-differentiation factor-15 （GDF-15） and left ventricular geometry in patients with essential hypertension. Methods 61 essential hypertension patients who achieved successful blood pressure control were studied with echocardiographic examination. According to left ventricular mass index （LVMI） and relative wall thickness （RWT）, patients were divided into left ventricular normal geometry group （n=13）, concentric remodeling group （n=15）, concentric hypertrophy group （n=18） and eccentric hypertrophy group （n=15）. 20 healthy subjects were enrolled as control. The levels of plasma GDF-15 were measured with enzyme linked immunosorbent assay （ELISA）. Results There was no significant difference in the level of plasma GDF-15 between the control group and the normal geometry group [（228.69 ± 113.45） vs. （233.32 ± 87.62） ng/L, P〉0.05]. Compared with the control group, the plasma GDF-15 levels were higher in the concentric remodeling group [（310.81 ± 95.48） vs. （228.69 ± 113.45） ng/L, P〈0.05], concentric hypertrophy group [（379.66 ± 114.57） vs. （228.69 ± 113.45） ng]L, P〈0.01] and eccentric hypertrophy group [（474.80 ± 85.14） vs. （228.69 ± 113.45） ng/L, P〈0.01]. The level of plasma GDF-15 in the concentric remodeling group was higher than that in the normal geometry group [（310.81 ± 95.48） vs. （233.32 ± 87.62） ng/L, P=0.048], but was similar with that in the concentric hype±rophy group [（310.81 ± 95.48） vs. （379.66 ± 114.57）, P=0.057]. The level of plasma GDF-15 in the eccentric hypertrophy group was higher than that in the concentric hypertrophy group [（474.80 ± 85.14） vs. （379.66 ± 114.57） ng/L, P=O.O09]. There was significant positive correlation between the levels of plasma GDF-15 and LVMI （P〈0.05） in patients with ventricular hypertrophy. Conclusion Left ventricular hypertrophy level can be best assessed by plasma GDF- 15 levels even in essential hypertension patients who achieve successful blood pressure control.