生长分化因子-15水平与急性冠脉综合征的相关性分析及其在预后中的价值

Serum Levels of GDF-15 in Acute Coronary Syndrom and Values in the Prognosis of Acute Coronary Syndrome

目的:针对生长分化因子-15(growth differentiation factor-15,GDF-15)与急性冠脉综合征(acute coronary syndrome,ACS)的相关性进行研究,并联合心肌梗死标记物三项[肌钙蛋白(c Tn I)、肌酸磷酸激酶同工酶(CKMB)、肌红蛋白(MYO)]来评估其在ACS患者预后中的价值。方法:106例住院患者,将其分成两组:ACS组73例,根据Global Registry of Acute Coronary Events(GRACE)危险评分将ACS组依次分为低危组、中危组、高危组三个亚组;行冠脉造影排除冠心病的33例患者为对照组。检测各组心梗三项等生化指标,运用ELISA法检测血清GDF-15水平,并随访入选的缩影患者的1年期主要不良心脏事件(major adverse cardiac events,MACE)。结果:与对照组相比,ACS组及其亚组(包括低危、中危、高危组)GDF-15水平均明显增高(P<0.01)。ACS亚组中,高危组GDF-15水平较低危组、中危组明显升高(P<0.05)。GRACE评分与ACS组GDF-15水平呈正相关(r=0.57,P<0.01)。ACS及其亚组GDF-15水平与c Tn I、CKMB、MYO水平均呈正相关性(r=0.55、0.56、0.59、0.54、P<0.01)。ACS组患者1年MACE发生率较对照组明显增加(P<0.001)。结论:ACS组及其亚组患者的GDF-15水平升高显著,与心梗三项、GRACE危险评分均呈正相关,可应用于预测ACS的MACE发生及评价其预后。

Objective：To approach the relationship between the levels of growth differentiation factor-15 （GDF-15） and acute coronary syndrome（ACS）,and combined with myocardial infarction three indicators（cTnI, CKMB,MYO） to assess the value in the prognosis of ACS.Method：A total of 106 hospitalized patients who were divided into two groups：ACS group（n=73） and the control group（n=33）.ACS group was divided into three sub-groups such as low-risk group,mid-risk group and high-risk group according to Global Registry of Acute Coronary Events（GRACE） risk score.33 cases of patients excluded coronary artery disease by coronary arteriography were treated as the control group.Biochemical indicators such as cTnI,CK-MB,MYO were tested in all groups.The levels of GDF-15 were determined by antibody-sandwich enzyme-linked immunosorbent assay（ELISA）.And the major adverse cardiac events（MACE） were followed up for one year.Result：Compared with the control group, the analysis showed that GDF-15 in ACS group and its sub-groups（low-risk group,mid-risk group and high-risk group） were significantly increased（P〈0.01）,GDF-15 increased obviously in high-risk group than low-risk group,mid-risk group（P〈0.05）.GDF-15 in ACS group had a positive correlation with GRACE risk score （r=0.57,P〈0.01）.GDF-15 was positively correlated with cTnI,CK-MB,and MYO（r=0.55,0.56,0.59, 0.54,P〈0.01） in ACS group and its sub-groups.The occurrence rate of MACE in one year was greated elevated in ACS group compared with the control group（P〈0.001）.Conclusion：The levels of GDF-15 in ACS group an sub-groups are markedly increased,also had a positive correlation with GRACE risk score and myocardial infarction three indicators.It can be used to evaluate the occurrence and prognosis of MACE in one year of ACS.