人血清生长分化因子15与器质性心脏病左心室重构程度的相关性研究  

Association Between Serum Growth Differentiation Factor 15 Level And Left Ventricular geometry In Patients With Organic Heart Disease

作　　者：张芃[1,2] 郑哲[1,2] 魏英杰[1] 胡盛寿[1,2] 段福建[3] 

机构地区：[1]北京协和医学院中国医学科学院阜外心血管病医院再生医学研究室,北京100037 [2]北京协和医学院中国医学科学院阜外心血管病医院外科,北京100037 [3]北京协和医学院中国医学科学院阜外心血管病医院超声科,北京100037

出　　处：《中国分子心脏病学杂志》2010年第2期81-85,共5页Molecular Cardiology of China

基　　金：长江学者和创新团队发展计划;中央级公益型科研院所基本科研业务费;国家科技支撑计划(2006BAI01A09);北京市科委重点计划(D0906004040391)

摘　　要：目的生长分化因子15(GDF-15)是近年发现的重要心血管疾病血清标记物。探讨人血清GDF-15水平是否与左室重构程度具有相关性。方法入选瓣膜性心脏病和冠心病患者156例。收集患者临床资料。采集外周静脉血,检测血清GDF-15水平。通过超声心动测定左室舒张末径、左室质量指数(LVMI)、左室相对室壁厚度等左室重构指标。通过统计学分析GDF-15水平与心血管危险因素、生化指标、左室重构指标的相关性。结果GDF-15水平与左房前后径(r=0.169,P=0.041)、左室舒张末径(r=0.431,P<0.001)、LVMI(r=0.428,P<0.001)呈显著正相关;与左室射血分数(r=-0.307,P<0.001)、左室相对室壁厚度(r=-0.254,P=0.002)呈显著负相关。多元线性回归分析示,控制了年龄、性别、心血管危险因素和生化指标后,GDF-15水平仍与LVMI呈显著正相关(标化的相关系数β=1.446,P<0.001)。GDF-15对左室肥大具有良好的诊断特性(AUC=0.737,95%置信区间为0.624～0.850,P=0.001)。结论血清GDF-15水平与左室重构程度呈独立、显著的相关性。为GDF-15作为心血管疾病血清标记物提供了病理生理基础。Objective Growth differentiation factor 15 （GDF-15） is emerging as an independent prognostic biomarker in patients with different cardiovascular diseases. We hypothesized that serum levels of GDF-15 were associated to the extent of left ventrieular （LV） remodeling. Methods To relate levels of GDF- 15 to indices of LV remodeling and function, serum levels of GDF-15 were measured in 156 patients with diagnosed valvular or coronary heart disease. The left ventricular remodeling was assessed by echocardiography, measuring LVEDD, left ventrictdar mass index （LVMI） and relative wall thickness （RWT）. Results Levels of GDF-15 were related to left atrium dimension （r = 0. 169, P = 0. 041 ）, LVEDD （ r = 0.431, P 〈 0.001 ）, LVMI （ r = 0. 428, P 〈 0. 001 ）, ejection fraction（ r = -0.307. P 〈 0. 001 ）, RWT （ r = - 0. 254, P = 0. 002 ）. The positive association between FSTL-1 and LVMI remained significant in a multivariate regression model adjusted for age, sex, conventional CV risk factors and established biomarkers, including NT-proBNP and high sensitivity C reactive protein （ standardized 13 = 0.422, P 〈 0. 001 ）. Reeeiver operating characteristic curve analyses further illustrated that GDF-15 is a strong marker of LV hypertrophy （ area under the curve, 0.737, 95% CI 0.624 to 0. 850）. Conclusion Serum levels of GDF-15 were independently associated with LVMI in patients with valvular and coronary heart disease, demonstrating that GDF-15 is involved in LV remodeling and supporting the clinical uses of GDF-15 as a cardiovascular biomarker.

关 键 词：生长分化因子15 生物标记物 心室重构 心力衰竭 

分 类 号：R541[医药卫生—心血管疾病]