生长分化因子15对急性冠状动脉综合征患者中期预后的预测价值  

Mid-term prognostic value of serum growth differentiation factor-15 in patients with acute coronary syndrome

作　　者：孙铃[1] 王庆捷[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院心内科,江苏省常州市213000

出　　处：《中国动脉硬化杂志》2017年第5期505-508,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的评估生长分化因子15(GDF-15)对急性冠状动脉综合征(ACS)患者中期预后的预测价值。方法连续入选95例急性冠状动脉综合征患者,采用酶联免疫吸附双抗体夹心法(ELISA)测定血浆GDF-15浓度,根据GDF-15中位数分为低浓度组和高浓度组,对出院患者进行定期随访,分别计算并比较2组患者的中期生存率以及主要不良心脏事件(MACE)发生率。生存率评估采用生存分析法。使用受试者工作特征(ROC)曲线分析GDF-15浓度对ACS患者的中期预后的预测价值。结果 ACS患者GDF-15浓度为921.56±462.20 ng/L,共随访患者95例,平均随访时间33.76±6.29月,死亡4例。生存分析提示GDF-15高浓度组患者的生存率低于GDF-15低浓度组(P=0.039)。GDF-15评估ACS患者中期生存的ROC曲线下面积(AUC)为0.853(SE=0.074,P=0.017,95%CI0.708~0.998),而GDF-15在预测ACS患者中期发生MACE的ROC曲线下面积为0.805(SE=0.068,P=0.000,95%CI 0.672~0.938)。结论 GDF-15可反映ACS患者的中期预后,作为一个有潜力的新标志物,能更好地帮助ACS患者进行危险分层及评估预后。Aim To evaluate the mid-term prognostic value of serum growth differentiation factor-15（GDF-15） in acute coronary syndrome（ACS）. Methods Totally 95 consecutive patients with acute coronary syndrome were included. Their baseline levels of serum growth differentiation factor-15 （GDF-15） were determined using enzyme-linked immunosorbent assay （ELISA）. The patients were divided into low concentration group and high concentration group according to median value of GDF-15. The mid-term survival rate and major adverse cardiovascular events （MACE） during the follow-up period were observed using Kaplan-Meier survival analysis method. Receiver operating characteristic （ROC） curve was measured to evaluate the mid-term prognostic value of serum growth differentiation factor-15 in acute coronary syndrome. Results There were 95 cases in the whole study including four deaths. The mean follow-up was 33.76±6.29 months. The serum growth differentiation factor-15 level in acute coronary syndrome patients were 921.56±462.20 ng/L. Survival analysis showed that survival rate in patients with high level of serum GDF-15 was statistically lower than low level of serum group （P=0.039）. The area under the ROC curve is 0.853（SE=0.074,P=0.017,95%CI 0.708~0.998）in evaluation of mid-term survival rate and 0.805（SE=0.068,P=0.000,95%CI 0.672~0.938）in predicating MACE. Conclusion GDF-15 level predicted mid-term prognosis in acute coronary syndrome. As a new biochemical marker, GDF-15 is of clinical significance in evaluating risk stratification and mid-term prognosis in acute coronary syndrome.

关 键 词：急性冠状动脉综合征 生长分化因子15 生存率 中期预后 

分 类 号：R541.4[医药卫生—心血管疾病]