GDF-15评估急性心力衰竭患者预后的临床价值  

Value of GDF-15 in predicting prognosis of patients with acute heart failure

作　　者：张丽[1] 王凯[1] 祝绪 郑旭辉 倪葛慧 程慧玲 王慧敏[1] 吴倩芸[1] 姚文明[1] 周芳[1] 周艳丽[1] 张海锋[1] 李新立[1] ZHANG Li;WANG Kai;ZHU Xu;ZHENG Xuhui;NI Gehui;CHENG Huiling;WANG Huimin;WU Qianyun;YAO Wenming;ZHOUFang;ZHOUYanli;ZHANG Haifeng;LI Xinli(Department of Cardiology,the First Affiliated Hospital with Naniing Medical University,Nan jing,210029,China)

机构地区：[1]南京医科大学第一附属医院心脏科,南京210029

出　　处：《临床心血管病杂志》2018年第7期691-695,共5页Journal of Clinical Cardiology

基　　金：国家科技支撑计划课题(No:2011BAI11B08);江苏省六大人才高峰资助项目[No:WSN-031(IB15)]

摘　　要：目的:探讨生长分化因子-15(GDF-15)在预测急性心力衰竭(心衰)患者长期预后中的临床价值。方法:纳入2012-04-2016-05因急性心衰发作入住我院的患者279例,进行为期1年的随访,定义终点事件为全因死亡,检测这些患者基线血样中GDF-15浓度,分析其对急性心衰长期预后的影响。结果:1年内死亡组与生存组的GDF-15水平存在显著差异(P<0.001)。ROC曲线显示,曲线下面积(AUC)为0.692,最佳预测值为4 526.0ng/L,敏感性为53.1%,特异性为80.9%。Kaplan-Meier生存曲线发现,GDF-15>4 526.0ng/L的高水平组全因死亡率明显升高(P<0.001),约为低水平组的3倍。Cox比例风险回归(向前逐步)模型提示,GDF-15为急性心衰患者1年终点事件的独立预测因子(HR:1.554,P=0.018)。结论:GDF-15用于评估急性心衰预后具有一定的临床价值。Objective：To investigate the clinical value of growth differentiation factor-15（GDF-15）in longterm prognosis of patients with acute heart failure（AHF）.Method：A total of 279 patients admitted to our hospital for AHF from 2012-04 to 2016-05 were enrolled and were followed up for one year.The primary endpoint event was defined as all-cause mortality.Measuring the concentration of GDF-15 in baseline blood samples obtained from these patients to analyze its effect on long-term prognosis of AHF.Result：There was a significant difference in GDF-15 levels between the death group and the survival group within one year（P〈0.001）.The ROC curve showed that the area under the curve（AUC）of GDF-15 was 0.692,the optimal cut off point was 4 526.0 ng/L,and sensitivity was 53.1%,specificity was 80.9%.The Kaplan-Meier survival curve found that the all-cause mortality rate in the group with GDF-15 〉4 526.0 ng/L was significantly higher（P〈0.001）,which was about three times that in the low-level group.The Cox proportional hazards regression（forward stepwise）model showed that GDF-15 was an independent predictor of 1-year endpoint events in patients with AHF（HR：1.554,P=0.018）.Conclusion：GDF-15 has certain clinical value for evaluating the prognosis of AHF.

关 键 词：心力衰竭 急性 生长分化因子-15 预后 

分 类 号：R541.6[医药卫生—心血管疾病]