血浆GDF-15水平与严重急性心力衰竭患者预后的相关性研究

Study on correlation between plasma GDF-15 level and prognosis on patients with severe acute heart failure

目的探讨严重急性心力衰竭(AHF)患者血浆生长分化因子-15(GDF-15)水平与预后的相关性。方法选取该院2015年9月至2017年3月收治的严重AHF患者168例,检测其血浆GDF-15水平,随访1年后绘制GDF-15水平预测严重AHF患者不良预后的受试者工作特征(ROC)曲线以及Kaplan-Meier曲线,并采用Cox比例风险模型分析GDF-15水平与严重AHF患者终点事件的相关性。结果ROC曲线分析显示,血浆GDF-15水平预测严重AHF患者不良预后的最佳截断值为3 980 ng/mL(灵敏度和特异度分别为90.3%和71.1%),以其为界值,Kaplan-Meier曲线分析显示,血浆GDF-15水平较高的AHF患者预后显著劣于GDF-15水平较低的患者(P<0.05)。校正混杂因素后,Cox比例风险模型分析显示,血浆GDF-15水平每升高1 000 ng/mL,严重AHF患者1年内死亡和再入院的风险将增加4.25倍[风险比(HR)=4.25,95%CI:1.93~19.29,P<0.05]。结论较高的血浆GDF-15水平与严重AHF患者的不良预后具有显著相关性。

Objective To investigate the correlation between plasma growth differentiation factor-15(GDF-15)level and the prognosis in the patients with severe acute heart failure(AHF).Methods One hundred and sixty eight patients with severe AHF in the hospital from September 2015 to March 2017 were selected.The plasma GDF-15 level was detected.After 1-year follow up,the receiver operating characteristic(ROC)curve of GDF-15 level for predicting the adverse prognosis in AHF patients and Kaplan-Meier curve were drawn.Moreover the Cox proportional hazards model was adopted to analyze the correlation between GDF-15 level and the endpoint event in the patients with severe AHF.Results The ROC curve showed that the best cut-off value of plasma GDF-15 level for predicting adverse event was 3 980 ng/mL with the sensitivity of 90.3%and specificity of 71.1%.With it as the critical value,the Kaplan-Meier curve revealed that the prognosis in the AHF patients with higher GDF-15 level was significantly inferior to that in the patients with low GDF-15 level(P<0.05).After correcting the confounding factors,the Cox proportional hazards model showed that per 1 000 ng/mL increase in GDF-15 level,the risk of death and re-hospitalization within 1 year would be increased by 4.25 folds[hazard ratio(HR)=4.25,95%CI:1.93-19.29,P<0.05].Conclusion Higher plasma GDF-15 level has a significant correlation with the adverse prognosis in the patients with severe AHF.