GDF-15与STEMI急诊PCI术后左室重构的相关性研究  

Correlation of Growth-differentiation Factor-15 and Left Ventricular Remodeling in ST-segment Elevation Myocardial Infarction Patients Treated with Emergency Percutaneous Coronary Intervention

作　　者：杨冉[1] 李明莉[1] 黄涛[2] 周彩丽[1] 王玲[1] 侯善荣[2] 

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261053 [2]潍坊医学院附属医院心内科

出　　处：《潍坊医学院学报》2015年第6期430-432,472,共4页Acta Academiae Medicinae Weifang

摘　　要：目的：探讨生长分化因子-15（GDF-15）水平与ST段抬高型心肌梗死（STEMI）急诊经皮冠状动脉介入治疗（PCI）术后半年左室重构（ LVR）程度的相关性，并评价其对LVR的预测价值。方法选择STEMI急诊PCI术后患者63例，入院24h内采集静脉血，测定血清N末端B型脑钠肽前体（ NT-proBNP），并留取血清标本，集中检测GDF-15表达水平。于入院后96h内及随访末（6个月）行超声心动图检测，左室重构定义为左室舒张末期容积较基线增加＞20％，据此将患者分成左室重构（ LVR）组（ n＝13）及非左室重构（NLVR）组（n＝50），分析两组入院24h内血清GDF-15表达水平与STEMI急诊PCI术后晚期左室重构的相关性。结果13例（20．63％）患者发生了左室重构，LVR组血清GDF-15水平显著高于NLVR组（P＜0．01）。 Logistic回归分析示GDF-15水平与LVR正相关（OR 1．006，P＜0．01）。 ROC曲线分析结果示：GDF-15曲线下面积（AUC）为0．763（95％置信区间0．623～0．903）。结论 STEMI急诊PCI术后患者血清GDF-15水平与LVR呈独立、显著的正相关。Objective To investigate the correlation between the level of GDF-15 and left ventricular remodeling in STEMI pa-tients treated with emergency PCI for 6 months.And to evaluate its predictive value of LVR.Methods Sixty-three patients with STEMI un-dergoing primary percutaneous coronary intervention（ PCI） were selected to the study.Blood samples for the determination of GDF-15 and N-terminal pro brain natriuretic peptide（ NT-proBNP） were obtained within the first 24 hours after symptom onset.Echocardiography was per-formed in all patients within the first 96 hours of admission and at 6 months of follow-up.LVR was defined as a 〉20% increase in the left ventricular end-diastolic volume at 6 months of follow-up compared to the baseline,which was divided into left ventricular remodeling（ LVR） group（n=13） and non left ventricular remodeling（NLVR） group（n=50）.The correlation of GDF-15 and LVR between the two groups were analyzed within the first 24 hours.Results Left ventricular remodeling occurred in 13 patients（20.63%）.The serum GDF-15 level in LVR group was significantly higher than that in NLVR group（P〈0.01）.Logistic regression analysis showed that the level of GDF-15 was positive-ly correlated with LVR（OR 1.006,P〈0.01）.ROC curve analysis showed that the area under the GDF-15 curve（AUC） was 0.763（95%confidence interval 0.623~0.903）.Conclusion GDF-15 level and LVR in patients with STEMI after emergency PCI are independently and significantly positive correlation.

关 键 词：心肌梗死 ST段抬高型 生长分化因子-15 左室重构 急诊PCI 

分 类 号：R541[医药卫生—心血管疾病]