血小板源性生长因子与老年心力衰竭预后的相关研究

Association between Platelet-derived Growth Factor and Prognosis of Older Patients with Heart Failure

目的探讨血清血小板源性生长因子(PDGF)水平在老年慢性心力衰竭(CHF)患者心衰严重程度及预后评估中的价值。方法选取2016年1月~2017年6月于宝鸡市中心医院就诊的144例老年CHF患者(CHF组)和100例健康体检的老年志愿者(对照组)为研究对象。检测血清PDGF水平、左室舒张末期内径(LVEDD)和左室射血分数(LVEF)等指标并进行统计分析;分析CHF组患者随访12个月内心脏事件的发生情况。结果CHF组血清PDGF水平显著高于对照组(P<0.001)。老年CHF患者血清PDGF水平与NYHA分级、血清N末端B型利钠肽原(NT-proBNP)水平、LVEDD均呈正相关关系(P=0.003;P=0.001;P=0.010),与LVEF呈负相关关系(P=0.007)。Logistic多因素回归分析结果显示高血清PDGF水平是老年CHF患者12个月内发生心脏事件的危险因素(P=0.005)。ROC曲线分析结果显示血清NT-proBNP和PDGF预测老年CHF患者12个月内发生心脏事件的曲线下面积分别为0.904和0.837,差异无统计学意义(P=0.119)。结论血清PDGF可能成为一种新的评估老年CHF患者病情严重程度和判断预后的血清学指标。

Objective To investigate the significance of platelet-derived growth factor(PDGF)for evaluation of severity and prognosis in older patients with chronic heart failure(CHF).Methods 144 older patients with CHF were assigned to CHF group,and 100 healthy individuals undergoing health examinations were assigned to the control group in Baoji Central Hospital from January 2016 to June 2017.Serum PDGF level,left ventricular end diastolic diameter(LVEDD)and 1eft ventricular ejection fraction(LVEF)were examined.The occurrence of cardiac events in CHF patients was followed up for 12 months.Results The serum PDGF level in CHF group was significantly higher than that in the control group(P<0.001).Correlation analysis showed that the serum PDGF level was positively correlated with NYHA classification,N-terminal pro-B-type natriuretic peptide(NT-proBNP)and LVEDD(P=0.003,P=0.001,P=0.010),and was negatively correlated with LVEF(P=0.007).Multivariate logistic regression analysis showed that high level of serum PDGF was risk factor for cardiovascular events in older patients with CHF(P=0.005)within 12 months.ROC curve analysis showed that the areas under ROC of serum level of NT-proBNP and PDGF in predicting cardiac events within 12 months were 0.904 and 0.837 respectively,there was no significant difference between them(P=0.119).Conclusion Serum PDGF might be used as a predictor for severity and prognosis in older patients with CHF.