生长分化因子-15对急性冠状动脉综合征患者急性肾损伤风险的预测价值

Value of growth differentiation factor-15 in predicting risk of acute kidney injury in patients with acute coronary syndrome

目的评估生长分化因子-15(GDF-15)对急性冠状动脉综合征(ACS)患者住院期间急性肾损伤(AKI)风险的预测价值。方法选取694例ACS患者作为研究对象,所有患者入院时留取静脉血,采用酶联免疫吸附法(ELISA)测定GDF-15水平,根据住院后是否发生AKI将患者分为实验组(AKI组)81例与对照组(非AKI组)613例。比较2组患者GDF-15水平,采用多因素Logistic回归分析评估GDF-15水平与ACS患者住院期间AKI风险的相关性,并采用受试者工作特征(ROC)曲线评估GDF-15对AKI风险的预测价值。结果694例ACS患者的AKI发生率为11.67%;实验组患者入院时GDF-15水平为(1320.24±281.71)ng/L,高于对照组的(979.88±319.77)ng/L,差异有统计学意义(P<0.05);GDF-15高表达是ACS患者住院期间发生AKI的独立危险因素(OR值为1.004,95%CI为1.003~1.005,P<0.001);血清GDF-15水平预测AKI风险的ROC曲线下面积(AUC)为0.774,95%CI为0.723~0.824。结论高水平GDF-15是ACS患者住院期间AKI风险的独立危险因素,对AKI风险具有较高的预测价值。

Objective To evaluate the value of growth differentiation factor-15(GDF-15)in predicting risk of acute kidney injury(AKI)in patients with acute coronary syndrome(ACS).Methods Totally 694 ACS patients were enrolled as research objects.Venous blood of all patients were collected at the time of admission.The expression levels of GDF-15 were measured by enzyme-linked immunosorbent assay(ELISA).The patients were divided into experimental group(AKI group,n=81)and control group(non-AKI group,n=613)according occurrence of AKI.GDF-15 levels between the two groups were compared.Multivariate logistic regression analysis was performed to analyze correlation between GDF-15 level and AKI risk during hospitalization in ACS patients.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of GDF-15 in AKI risk.Results The occurrence of AKI in 694 patients was 11.67%.GDF-15 level at admission in the experimental group was higher than that in the control group[(1320.24±281.71)versus(979.88±319.77)ng/L,P<0.05].High expression of GDF-15 was an independent risk factor of AKI in ACS patients during hospitalization(OR:1.004,95% confidence interval(CI):1.003-1.005,P<0.001).The area under the curves(AUC)of plasma GDF-15 was 0.774,with 95%CI of 0.723 to 0.824.Conclusion High level of GDF-15 is an independent risk factor of AKI in ACS patients,which has a higher predictive value for AKI.