冠心病合并慢性心力衰竭患者GDF15、BNP、sST2的表达及其与心功能的相关性

Expression of GDF15, BNP and sST2 in Patients with Coronary Heart Disease Complicated with Chronic Heart Failure and Its Correlation with Cardiac Function

目的研究冠心病合并慢性心力衰竭患者生长分化因子15(growth differentiation factor 15,GDF15)、脑利钠肽(brain natriuretic peptide,BNP)、可溶性ST2(soluble ST2,sST2)的表达及其与心功能的相关性。方法选取2014年1月—2018年1月我院收治的82例冠心病合并慢性心力衰竭患者作为观察组,根据纽约心脏病协会心功能分级标准,分为心功能Ⅱ级组(n=16)、心功能Ⅲ级组(n=46)、心功能Ⅳ级组(n=20)。选取60例同期于我院进行健康体检的健康者作为对照组。检测GDF15、BNP、sST2水平及心功能相关指标,分析GDF15、BNP和sST2与心功能的相关性。结果与对照组比较,观察组GDF15、BNP、sST2、左室前后径(left anterior and posterior diameter,LAD)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)和左室心肌质量指数(left ventricular myocardial mass index,LVMI)上升,左室相对室壁厚度(left ventricular relative wall thickness,RWT)和左室射血分数(left ventricular ejection fraction,LVEF)降低,差异有统计学意义(P<0.01)。不同心功能的冠心病合并慢性心力衰竭患者GDF15、BNP、sST2、LAD、LVEDD、LVMI、RWT和LVEF比较均有统计学意义(P<0.05);与心功能Ⅱ级组比较,心功能Ⅲ级组、心功能Ⅳ级组GDF15、BNP、sST2、LAD、LVEDD和LVMI升高,RWT和LVEF降低,差异有统计学意义(P<0.05);与心功能Ⅲ级组比较,心功能Ⅳ级组GDF15、BNP、sST2、LAD、LVEDD和LVMI明显上升,RWT和LVEF显著降低,差异有统计学意义(P<0.05)。Pearson相关性分析显示,GDF15、BNP和sST2与心功能均呈正相关(P<0.05)。结论冠心病合并慢性心力衰竭患者GDF15、BNP和sST2呈较高水平表达,且随着心功能分级的升高而逐渐上升,可作为临床评估冠心病合并慢性心力衰竭患者病情严重程度的有效指标。

Objective To investigate the expression of growth differentiation factor 15(GDF15),brain natriuretic peptide(BNP)and soluble ST2(sST2)in patients with coronary heart disease(CHD)complicated with chronic heart failure(CHF)and its correlation with cardiac function.Methods Eighty-two patients with CHD complicated with CHF who were admitted to our hospital from January 2014 to January 2018 were selected as observation group.According to the classification standard of cardiac function in New York Heart Association,they were divided into cardiac function grading II group(n=16),cardiac function grading III group(n=46),and cardiac function grading IV group(n=20).Sixty healthy people who underwent physical examination in our hospital were selected as control group.GDF15,BNP,sST2 levels and related indicators of cardiac function were measured,and the correlation between GDF15,BNP,sST2 and cardiac function was analyzed.Results Compared with the control group,GDF15,BNP,sST2,left anterior and posterior diameter(LAD),left ventricular end diastolic diameter(LVEDD)and left ventricular myocardial mass index(LVMI)in the observation group were increased,while left ventricular relative wall thickness(RWT)and left ventricular ejection fraction(LVEF)were decreased,and the difference was statistically significant(P<0.01).The difference in GDF15,BNP,sST2,LAD,LVEDD,LVMI,RWT and LVEF between patients with CHD and CHF and with different cardiac functions were statistically significant(P<0.05).Compared with cardiac function grading II group,GDF15,BNP,sST2,LAD,LVEDD and LVM1 were increased in cardiac function gradingⅢgroup and gradingⅣgroup,and RWT and LVEF were decreased,suggesting significant difference(P<0.05).Compared with cardiac function gradingⅢgroup,the GDF15,BNP,sST2,LAD,LVEDD and LVMI in cardiac function gradingⅣgroup were increased significantly,and the RWT and LVEF were decreased significantly(P<0.05).Pearson correlation analysis showed that GDF15,BNP and sST2 were positively correlated with cardiac function(P<0.05).Conclusion GDF15,BNP and sST2 are highly expressed in patients with CHD complicated with CHF,and the levels gradually increase with the increasing of cardiac function grading.Therefore,it can be used as an effective indicator for clinical evaluation of the severity of disease in CHD patients with CHF.