血清生长分化因子15和聚腺苷酸二磷酸核糖聚合酶1在老年心力衰竭并发心律失常患者血清中的表达及其临床预后评估价值

Expression and clinical prognostic value of growth differentiation factor 15 and polyadenyldiphosphate ribose polymerase 1 in serum of the elderly patients with heart failure complicated with arrhythmia

目的分析血清生长分化因子15(GDF15)、聚腺苷酸二磷酸核糖聚合酶1(PARP1)水平对老年心力衰竭(心衰)并发心律失常患者预后的评估价值。方法选取2021年1月至2022年6月在湖北省天门市第一人民医院诊治的180例老年心衰并发心律失常患者为观察组,及同期180例老年慢性心衰但未发心律失常患者为对照组。采用酶联免疫吸附(ELISA)法检测老年心衰并发心律失常患者血清GDF-15、PARP1水平;Logistic回归分析影响老年心衰并发心律失常患者预后的因素;受试者工作特征(ROC)曲线分析血清GDF-15、PARP1水平对老年心衰并发心律失常患者预后的预测价值。结果与对照组相比,观察组血清GDF-15、PARP1水平明显升高(P<0.05);随着心功能分级的增加,老年心衰并发心律失常患者血清GDF-15、PARP1水平依次明显升高(P<0.05);与预后良好组相比,预后不良组老年心衰并发心律失常患者血清GDF-15、PARP1水平显著升高(P<0.05);Logistic回归分析发现,心功能分级、GDF-15、PARP1是影响老年心衰并发心律失常患者预后的危险因素(P<0.05),左心室射血分数(LVEF)是影响患者预后的保护因素(P<0.05);血清GDF-15、PARP1二者联合预测老年心衰并发心律失常患者预后的ROC曲线下面积(AUC)为0.908,均优于其各自单独预测(Z二者联合-GDF-15=1.871,P=0.031;Z二者联合-PARP1=2.847,P=0.002)。结论老年心衰并发心律失常患者血清GDF-15、PARP1水平升高,与患者预后有关,对老年心衰并发心律失常患者预后具有一定的预测价值。

Objective To explore the prognostic value of serum growth differentiation factor 15(GDF15)and polyadenyldiphosphate ribose polymerase 1(PARP1)levels in the elderly patients with heart failure complicated with arrhythmia.Methods A total of 180 elderly patients with heart failure complicated with arrhythmia who were treated in The First People’s Hospital of Tianmen in Hubei Province from January 2021 to June 2022 were regarded as the observation group,and 180 elderly patients with heart failure complicated without arrhythmia in the same period were regarded as the control group.The serum levels of GDF-15 and PARP1 were detected by enzyme linked immunosorbent assay(ELISA);Logistic regression analysis was performed analysing the factors affecting the prognosis of the elderly patients with heart failure complicated with arrhythmia;the predictive value of serum GDF-15 and PARP1 levels for the prognosis of elderly patients with heart failure complicated with arrhythmia were analyzed by ROC curve.Results Compared with the control group,the serum levels of GDF-15 and PARP1 were significantly higher in the observation group(P<0.05);with the increase of cardiac function grading,serum GDF-15 and PARP1 in the observation groups were increased obviously(P<0.05);compared with the good prognosis group,the serum levels of GDF-15 and PARP1 in the poor prognosis group were obviously higher(P<0.05).Logistic regression analysis showed that cardiac function grade,levels of GDF-15 and PARP1 were the risk factors affecting the prognosis of elderly patients with heart failure complicated with arrhythmia(P<0.05),and left ventricular ejection fraction(LVEF)was a protective factor affecting the prognosis of the patients(P<0.05).The area under the ROC curve(AUC)of the combination of serum GDF-15 and PARP1 in predicting the prognosis of elderly patients with heart failure complicated with arrhythmia was 0.908,which was better than their independent prediction(Zcombination-GDF-15=1.871,P=0.031;Zcombination-PARP1=2.847,P=0.002).Conclusion The levels of serum GDF-15 and PARP1 in the elderly patients with heart failure complicated with arrhythmia increase;they are related to the prognosis of the patients and have certain predictive value for the prognosis of the elderly patients with heart failure complicated with arrhythmia.