老年急性冠脉综合征患者血清生长分化因子-15的表达及其临床意义

Serum level and clinical significance of growth differentiation factor-15 in the elderly patients with acute coronary syndrome

目的观察生长分化因子-15(GDF-15)在老年急性冠脉综合征(ACS)患者血清中的变化及其对近期预后的预测价值。方法选取老年ACS患者116例,分为急性心肌梗死(AMI)组46例,不稳定型心绞痛(UAP)组70例,同时设同期因胸痛、胸闷症状入院经冠脉造影排除冠心病的对照组40例。采集空腹外周血,采用酶联免疫法测定患者血清GDF-15浓度。对ACS患者随访6月,记录其心血管不良事件的发生情况。结果 AMI组GDF-15水平为(815.41±227.54)ng/L,显著高于UAP组[(735.06±144.94)ng/L,P<0.05]与对照组[(641.97±143.90)ng/L,P<0.01]。同时UAP组与对照组GDF-15水平比较差异也有统计学意义(P<0.01)。发生心血管事件组GDF-15水平高于未发生心血管事件组(P<0.01)。结论 GDF-15水平在老年ACS患者中明显升高,其升高程度与ACS的类型有关,GDF-15可作为判断老年ACS近期预后的指标。

Objective To investigate the changes and the short-term prognosis value of growth differentiation factor- 15 （GDF-15）in the elderly patients with acute coronary syndrome（ACS）. Methods 116 ACS patients including 46 cases of acute myocardial infarction （AMI） and 70 cases of unstable angina pectoris （ UAP ） were selected. And 40 cases with normal coronary angiography （CAG） were chosen as control group. The serum level of GDF-15 was determined by ELISA. In the meantime, all ACS patients were followed up for six months and the adverse cardiovascular events （ACEs） were recorded. Results The GDF-15 level of AMI group was 815.41±227. 54 ng/L, which was significantly higher than that of UAP group （735.06± 144. 94 ng/L, P〈0. 05） and control group （641.97± 143.90 ng/L, P〈0. 01 ）. The level of serum GDF-15 was of significant difference between UAP group and control group （P〈0. 01 ）. GDF-15 level was significantly higher in the patients suffering from ACEs（P〈0. 01 ）. Conclusions The GDF-15 level is obviously higher in the elderly patients with ACS and is dependent on the type of ACS. The serum level of GDF-15 is associated with short-term prognosis in the elderly patients with ACS.