血清GDF-15水平与冠状动脉病变严重程度和预后的关系

Correlation of serum level of growth differentiation factor 15 and severity and prognosis of coronary heart disease

目的探讨血清生长分化因子15(GDF-15)与冠心病患者冠状动脉病变严重程度和预后的关系。方法行冠状动脉造影确诊为冠心病的患者118例分成三组:A组37例,单支病变;B组42例,两支病变;C组39例,多支病变。采用ELISA法测定各组手术前血清GDF-15水平,出院后第6、12和24个月电话随访患者主要心血管事件(MACE)的发生情况。结果血清GDF-15水平随病变严重程度加重而升高(P<0.01)。随访期间,A组无MACE发生,C组MACE发生率15.3%,高于B组的4.7%(P<0.01)。C组患者GDF-15高表达是其随访期内发生MACE的危险因素(OR=1.011,P=0.018)。结论血清GDF-15水平升高提示冠心病患者冠状动脉的病变程度较重,提示预后较差。

Objective To investigate the correlation of serum level of growth differentiation factor 15（GDF15） and the severity and prognosis of coronary heart disease（CHD）. Methods A total of 118 patients was assigned into three groups, who were with single vessel disease（group A, 37 cases） ,two vessels disease（group B,42 cases） or more than two vessels disease（group C, 39 cases）. Serum level of GDF15 was detected by ELISA. The patients were followed up by telephone in the 6th, 12^h and 24th month after discharged from hospital and the incidence of main cardiovascular events （MACE） was counted. Results Serum level of GDF15 was in an order of group A〈group B〈group C [-（1251.6±1081.1） ng/L vs. （1503.4±- 1265.3） ng/L vs. （2922.5 ± 2703.6） ng/L] （P〈0. 01）. During follow up, there was no occurrence of MACE in group A. The incidence of MACE in group C was 15.3% ,which was higher than 4. 7% in group B（P〈0. 01）. The high expression of GDF-15 was an independent risk factor for MACE in group C（OR= 1. 011, P=0. 018）. Conclusion High serum level of GDF-15 may indicate a higher severity of CHD and predict a relatively poor prognosis.