血清GDF-15、TGF-β1及HbAc1与冠心病患者PCI围术期心肌损伤的相关性分析

The Correlation of Serum GDF-15,TGF-β1 and HbA1c with Perioperative Myocardial Injury in Patients with Coronary Heart Disease Undergoing PCI

目的 探究血清生长分化因子15(GDF-15)、转化生长因子-β1(TGF-β1)及糖化血红蛋白(HbA1c)与冠心病患者经皮冠状动脉介入治疗(PCI)围术期心肌损伤(PMI)的相关性。方法 以2020年1月至2023年1月108例冠心病患者及53例健康体检者为研究对象,根据PCI围术期PMI发生情况将冠心病患者分为PMI组及非PMI组。比较冠心病组、对照组及PMI组、非PMI组血清GDF-15、TGF-β1、HbA1c及肌钙蛋白T(cTnT)水平,分析血清指标与cTnT水平的相关性,并对血清GDF-15、TGF-β1及HbA1c水平联合检测对PMI的评估价值进行分析。结果 冠心病组的血清GDF-15、TGF-β1、HbA1c及cTnT水平均高于对照组(P<0.05)。PMI组手术前及手术后的血清GDF-15、TGF-β1、HbA1c水平均高于非PMI组,术后cTnT水平高于非PMI组(P<0.05);PMI组手术前后血清GDF-15、TGF-β1、HbA1c及cTnT水平差值均大于非PMI组(P<0.05)。血清GDF-15、TGF-β1及HbA1c水平与cTnT水平呈正相关(r=0.527、0.356、0.419,P<0.05)。血清指标联合检测评估PMI的AUC值(0.960)大于血清GDF-15、TGF-β1、HbA1c水平单独检测(0.814、0.848、0.889,P<0.05)。结论 冠心病PMI患者血清GDF-15、TGF-β1、HbA1c水平与PMI程度有关,且各指标联合检测对PMI具有评估价值。

Objective To explore the correlation between serum growth differentiation factor 15(GDF-15),transforming growth faction-β1(TGF-β1)and glycosylated hemoglobin(HbA1c)and perioperative myocardial injury(PMI)in patients with coronary heart disease undergoing percutaneous coronary intervention(PCI).Methods 108 patients with coronary heart disease and 53 healthy subjects with physical examination from January,2020 to January 2023 were selected as the study subjects.According to the PMI occurrence during perioperative PCI,patients with coronary heart disease were divided into PMI group and non-PMI group.Serum GDF-15,TGF-β1,HbA1c and cardiac troponin T(cTnT)levels were compared between CHD group and the control group and also between PMI group and non-PMI group.The correlation between serum indicators and cTnT level was analyzed,and the clinical prediction value of combined detection of serum GDF-15,TGF-β1 and HbA1c on PMI was analyzed.Results The levels of serum GDF-15,TGF-β1,HbA1c and cTnT in the coronary heart disease group were higher than those in the control group(P<0.05).Serum GDF-15,TGF-β1 and HbA1c levels in PMI group before and after surgery were higher than those in non-PMI group,and the cTnT level after surgery was higher than that in non-PMI group(P<0.05).The differences of serum GDF-15,TGF-β1,HbA1c and cTnT before and after surgery were higher in PMI group than those in non-PMI group(P<0.05).Serum GDF-15,TGF-β1 and HbA1c levels were positively correlated with cTnT level(r=0.527,0.356,0.419,P<0.05).The AUC value of combined detection of serum indicators(0.960)was higher than that of single-marker detection of serum GDF-15(0.814),TGF-β1(0.848)or HbA1c(0.889)(P<0.05).Conclusion The levels of serum GDF-15,TGF-β1 and HbA1c in patients with coronary heart disease undergoing PCI are related to the degree of PMI,and the combined detection of all indicators has a predictive value on PMI.