摘要
目的分析血清生长分化因子-15(GDF-15)水平与慢性充血性心力衰竭(CHF)患者心功能及左心室重构的关系。方法选择2015年12月~2017年12月于湖北省中西医结合医院心内科收治的CHF患者为病例组(n=90),病例组根据美国纽约心脏病协会(NYHA)心脏功能分级分为NYHAⅡ级(n=28)、NYHAⅢ级(n=35)和NYHAⅣ级(n=27),并以同期入院进行体检的48例健康人群为对照组(n=48)。收集比较两组基线资料;分析病例组不同NYHA分级患者与对照组在血清GDF-15水平、N末端前体B型利钠肽(NT-proBNP)水平及左心室重构指标包括左室舒张末期内径(LVEDD)、左房收缩末期内径(LAD)、左室射血分数(LVEF)和左室短轴缩短率(FS)的差异;分析GDF-15与NT-proBNP水平及左心室重构指标的相关性。结果病例组的心率、收缩压和舒张压值均明显高于对照组,差异均有统计学意义(P<0.05)。NYHAⅡ级组、NYHAⅢ级组和NYHAⅣ级组的血清GDF-15、NT-proBNP水平、LVEDD及LAD值均高于对照组,且随着NYHA级别的升高而增高,差异均有统计学意义(P<0.05);而各NYHA级组的LVEF和FS值均低于对照组,且随着NYHA级别的升高而降低,差异均有统计学意义(P<0.05)。血清GDF-15水平与NT-proBNP水平、LVEDD及LAD值均呈正相关关系(r=0.598、0.443、0.489,P<0.05),而与EF和FS值呈负相关性(r=-0.617、-0.603,P<0.05)。结论血清GDF-15水平与CHF患者的心功能和左心室重构均有关,可能作为CHF患者诊断、病情评估的标志物。
Objective To analyze the relationship among serum growth differentiation factor-15(GDF-15)level,cardiac function and left ventricular remodeling in patients with chronic congestive heart failure(CHF).Methods From December 2015 to December 2017,CHF patients were selected as the case group(n=90).The case group was divided into NYHAⅡaccording to the New York Heart Association(NYHA)cardiac function classification.Forty-eight healthy subjects(n=28),NYHA classⅢ(n=35),and NYHAIV class(n=27),who were admitted to the hospital at the same time as the control group(n=48).The baseline data of the two groups were collected and compared.The serum GDF-15 level,N-terminal precursor B-type natriuretic peptide(NT-proBNP)level and left ventricular remodeling index including left ventricular end-diastolic stage were analyzed in different NYHA patients and control groups.Internal diameter(LVEDD),left atrial systolic diameter(LAD),left ventricular ejection fraction(EF),and left ventricular short axis shortening rate(FS).The correlation between GDF-15 and NT-proBNP levels and left ventricular remodeling index was analyzed.Results The heart rate,systolic blood pressure and diastolic blood pressure of the case group were significantly higher than the control group,and the difference was statistically significant(P<0.05).Serum GDF-15,NT-proBNP levels,LVEDD and LAD values in NYHAⅡgroup,NYHA classⅢgroup and NYHAIV group were higher than those in the control group,and increased with the increase of NYHA level,the difference was statistically significant(P<0.05).The EF and FS values of the NYHA group were lower than those of the control group,and decreased with the increase of NYHA level,the difference was statistically significant(P<0.05).Serum GDF-15 levels were positively correlated with NT-proBNP levels,LVEDD and LAD values(r=0.598,0.443,0.489,P<0.05),but negatively correlated with EF and FS values(r=-0.617,-0.603,P<0.05).Conclusion Serum GDF-15 level is related to cardiac function and left ventricular remodeling in CHF patients,and can be used as a marker for diagnosis,evaluation of CHF patients.
作者
郭丽芬
胡晓军
晏凯利
Guo Lifen;Hu Xiaojun;Yan Kaili(Department of Cardiology,Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine)
出处
《中国循证心血管医学杂志》
2019年第9期1069-1072,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
湖北省自然科学基金项目(2014CFB657)
关键词
慢性充血性心力衰竭
生长分化因子-15
N末端前体B型利钠肽
心功能
左心室重构
Chronic congestive heart failure
Growth differentiation factor-15
N-terminal precursor B-type natriuretic peptide
Heart function
Left ventricular remodeling
