急性心肌梗死患者介入治疗术中无复流现象与生长分化因子15的相关性  

Relations between growth differentiation factor-15 and no-reflow in patients with acute myocardial infraction

作　　者：孙铃[1] 臧璇[1] 张良峰[1] 宋瑛[1] 陈新[1] 李海燕[1] 王新[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6期599-603,共5页Chinese Journal of Arteriosclerosis

摘　　要：目的观察经皮冠状动脉介入治疗术中出现无复流现象的急性心肌梗死(AMI)患者生长分化因子15(GDF-15)的表达水平,探讨其对无复流现象的预测价值。方法连续入选南京医科大学附属常州市第二人民医院心血管内科住院的急性心肌梗死患者共243例,入院后24 h内抽血测定GDF-15浓度,并根据介入手术中是否出现无复流现象分为无复流组与血流正常组,比较两组GDF-15表达水平的差异,评估GDF-15对无复流现象的预测价值。结果无复流组44例,平均年龄67.00±13.04岁,血流正常组(对照组)199例,平均年龄65.54±12.98岁。无复流组患者GDF-15浓度高于血流正常组患者(1073.43±364.38 ng/L比714.10±340.98 ng/L,P<0.001)。GDF-15预测无复流现象的受试者工作特征曲线下面积(AUC)为0.829,95%CI为0.766~0.892。多因素回归分析提示GDF-15(OR:1.003,95%CI:1.001~1.004,P<0.001)和女性(OR:2.996,95%CI:1.358~6.610,P=0.007)是无复流现象的独立危险因素。结论 GDF-15和女性是急性心肌梗死患者介入治疗中无复流现象的独立危险因素。Aim To evaluate the effect of growth differentiation factor-15 （GDF-15） in predicting no-reflow in patients with acute myocardial infraction （AMI） undergoing percutaneous coronary intervention （PCI）.Methods Totally 243 consecutive patients with AMI were enrolled and serum GDF-15 levels were measured within 24 hours.All patients were divided into two groups according to the occurrence of no-reflow during PCI.Results There were 44 patients in no-reflow group （average age was 67.00± 13.04） and 199 patients in normal-reflow group （average age was 65.54±12.98）.The serum GDF-15 levels increased in no-reflow group （1073.43±364.38 ng/L vs 714.10±340.98 ng/L,P〈0.001）.The area under the receiver operating characteristic curves （AUC） was 0.829 （95%CI：0.766～0.892）.Logistic regression showed that GDF-15 （OR：1.003,95% CI：1.001～1.004,P〈0.001） and female （OR：2.996,95%CI：1.358～6.610,P=0.007） were independent risk factors for no-reflow during PCI in AMI patients.Conclusion GDF-15 and female were independent risk factors for no-reflow during PCI in AMI patients.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 生长分化因子15 无复流 

分 类 号：R5[医药卫生—内科学]