血清生长分化因子-15与N末端B型利钠肽原联合检测在心肺复苏成功后患者近期预后评估中应用价值的研究  

Application Value on Combined Examination of Blood Levels of GDF-15 and NT-proBNP in Patients After Successful Cardiopulmonary Resuscitation for Their Recent Prognosis

作　　者：任长安[1] 于海侠[1] 武会志 周大鹏[1] 杜金龙[1] 周景霞[1] 

机构地区：[1]承德市中心医院急诊科,河北省067000

出　　处：《中国循环杂志》2016年第12期1184-1188,共5页Chinese Circulation Journal

基　　金：承德市科学技术研究与发展计划项目(20142009)

摘　　要：目的 ：探讨血清生长分化因子-15（GDF-15）与N末端B型利钠肽原（NT-pro BNP）联合检测在心肺复苏（CPR）成功后患者近期预后评估中的应用价值。方法：选取我院心脏骤停CPR成功的患者共102例,分别检测其CPR后即刻、12 h、24～48 h的血清GDF-15水平,并根据血清GDF-15水平升高时间分为3组,A组（31例）：CPR后即刻、12 h和24～48 h血清GDF-15水平一直〈1200 ng/L;B组（35例）：CPR后12 h和24～48 h血清GDF-15水平持续升高,且一直〉1200 ng/L;C组（36例）：CPR后12 h和24～48 h血清GDF-15水平持续升高,但24～48 h较12 h时降低。同时检测3组患者各时间点血清NT-pro BNP水平及左心室射血分数（LVEF）。随访3组患者CPR后6个月的死亡情况。结果：血清GDF-15和NT-pro BNP具有交互作用（P〈0.05）,即NT-pro BNP表达水平随着血清GDF-15水平变化而变化;血清GDF-15与LVEF呈负相关（r=-0.530,P〈0.001）。血清GDF-15水平高表达者（〉1800 ng/L）、血清NTpro BNP水平高表达者（〉400 pg/ml）死亡率均高于血清GDF-15、NT-pro BNP水平低表达者（P〈0.05）;生存分析结果显示,B组患者6个月生存率低于A组及C组（P〈0.05）;A组和C组比较,差异无统计学意义（P〉0.05）。结论：血清GDF-15与NT-pro BNP联合检测能较好地预测CPR患者的近期临床预后。Objective： To explore the application value on combined examination of blood levels of growth differentiation factor-15（GDF-15） and NT-pro B-type natriuretic peptide（NT-pro BNP） in patients after successful cardiopulmonary resuscitation（CPR） for their recent prognosis.Methods： A total of 102 patients with sudden cardiac arrest and successful CPR in our hospital were enrolled. Blood levels of GDF-15 were examined at immediately, 12 h and 24-48 h after CPR respectively. According to GDF-15 levels, the patients were divided into 3 groups： Group A, the patients with GDF-15〈1200 ng/L at all-time points, n=31; Group B, GDF-15 level consistently increasing and GDF-15〉1200 ng/L at all-time points, n=35; Group C, GDF-15 level consistently increasing at 12 h and 24-48 h after CPR, while it was lower at 24-48 h than 12 h after CPR, n=36. Blood levels of NT-proB NP and left ventricular ejection fraction（LVEF） were also examined. The patients were followed-up for 6 months for post-CPR death.Results： Blood levels of GDF-15 and NT-pro BNP were related, NT-pro BNP level was changing with GDF-15 varying. GDF-15 and NT-pro BNP level was negatively related to LVEF（r=-0.530, P〈0.001）, the patients with GDF-15〉1800 ng/L and NT-proB NP400 pg/ml had the higher mortality than those had the lower levels of GDF-15 and NT-proB NP, P〈0.05. Survival analysis presented that 6 months survival rate in Group B was lower than Group A and Group C, P〈0.05; survival rate wassimilar between Group A and Group C, P〈0.05.Conclusion： Combined examination for blood levels of GDF-15 and NT-pro BNP may better predict the recent prognosis in patients who received CPR.

关 键 词：心肺复苏术 生长分化因子 N末端B型利钠肽原 预后 

分 类 号：R541.4[医药卫生—心血管疾病]