生长分化因子15和细胞因子对老年冠心病合并衰弱病人的诊断价值

Diagnostic value of growth differentiation factor 15 and cytokines in elderly patients with coronary heart disease complicated with frailty

目的探讨生长分化因子15(GDF15)和细胞因子对老年CHD合并衰弱病人的诊断价值。方法选取徐州医科大学附属医院在2022年7~9月间收治的88例老年CHD病人为研究对象,根据Frail衰弱量表分为衰弱组(27例)和非衰弱组(61例)。比较2组间一般资料、血清GDF15水平、细胞因子水平;绘制ROC曲线,分析GDF15及细胞因子对老年CHD合并衰弱的诊断价值。结果衰弱组年龄、年龄修正查尔森共病指数(age-adjusted Charlson comorbidity index,ACCI)、IL-1β、IL-5、IL-6、IL-10、IFN-α、IFN-γ、TNF-α和GDF15水平均明显高于非衰弱组(P<0.05)。ROC曲线分析显示,IFN-α、IFN-γ、GDF15联合诊断老年CHD病人合并衰弱的敏感度和特异度分别为85.19%和78.69%(AUC=0.868,95%CI:0.798~0.942),优于单项指标的诊断价值(P<0.05)。结论IFN-α、IFN-γ、GDF15单独或联合均可作为老年CHD病人合并衰弱的诊断指标,且联合诊断的效能更高。

Objective To investigate the diagnostic value of growth differentiation factor 15(GDF15)and cytokines in the elderly patients with coronary heart disease(CHD)complicated with frailty.Methods A total of 88 elderly CHD patients treated at the Affiliated Hospital of Xuzhou Medical University from July to September 2022 were enrolled in this study.According to the Frail scale,the patients were divided into the frailty group(27 cases)and the non-frailty group(61 cases).The general data,serum levels of GDF15 and cytokines of the two groups were detected and compared.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of GDF15 and cytokines for frailty in the elderly patients with CHD.Results The age,age-adjusted Charlson comorbidity index(ACCI)and the levels of GDF15,interleukin-1β(IL-1β),IL-5,IL-6,IL-10,interferon-α(IFN-α),IFN-γand tumor necrosis factor-α(TNF-α)in the frailty group were significantly higher than those in the non-frailty group(P<0.05).The area under the ROC curve(AUC)showed that the combined diagnosis of IFN-α,IFN-γ and GDF15 for frailty in the elderly CHD patients was superior to the diagnostic value of each single indicator(P<0.05).Conclusions IFN-α,IFN-γ and GDF15 can serve as diagnostic indicators for frailty in the elderly CHD patients,and the efficacy of the combination of three indicators is higher.