血清肝细胞生长因子、生长分化因子-15在慢性心力衰竭患者的表达及其意义  

Expression of serum HGF and GDF-15 in patients with chronic heart failure and its clinical significance

作　　者：丁才智 李剑峰[1] 任力[1] 赵春艳[1] 杨祥松 李承彬[2] 周义正[2] DING Caizhi;LI Jianfeng;REN Li;ZHAO Chunyan;YANG Xiangsong;LI Chengbin;ZHOU Yizheng(Songzi People's Hospital,Songzi 434200,China)

机构地区：[1]松滋市人民医院,湖北松滋434200 [2]荆州市中心医院

出　　处：《山东医药》2019年第22期12-15,共4页Shandong Medical Journal

基　　金：湖北省科技计划项目(2014CFB303)

摘　　要：目的探讨慢性心力衰竭患者血清肝细胞生长因子(HGF)、生长分化因子-15(GDF-15)水平及其临床意义。方法收集慢性心力衰竭患者107例,NYHA心功能分级为Ⅱ级36例、Ⅲ级41例、Ⅳ级30例,并于同期随机选取50例健康体检者为对照。采用酶联免疫吸附法检测血清HGF、GDF-15水平,多普勒超声心动图诊断仪测定左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF),ROC曲线评估血清HGF、GDF-15对慢性心力衰竭患者不良预后的预测价值。结果与健康体检者比较,慢性心力衰竭患者血清HGF、GDF-15水平升高,LVESD、LVEDD增大,LVEF减小(P均<0.05)。慢性心力衰竭患者随着NYHA分级增加,血清HGF、GDF-15水平逐渐升高,LVESD、LVEDD逐渐增大,LVEF逐渐减少(P均<0.05)。HGF与LVESD、LVEDD呈正相关(r=0.672、0.619,P均<0.05),与LVEF呈负相关(r=-0.658,P<0.05);GDF-15与LVESD、LVEDD呈正相关(r=0.736、0.702,P均<0.05),与LVEF呈负相关(r=-0.691,P<0.05)。慢性心力衰竭患者不良心血管事件发生率为49.53%。HGF预测不良心血管事件的AUC为0.805,最佳截断值为1008.95pg/mL,灵敏度、特异性分别为0.73、0.82,准确度为0.79;GDF-15预测不良心血管事件的AUC为0.849,最佳截断值为1226.72pg/mL,灵敏度、特异性分别为0.78、0.85,准确度为0.80;HGF联合GDF-15预测不良心血管事件的AUC为0.923,灵敏度、特异性分别为0.86、0.89,准确度为0.87。结论血清HGF、GDF-15表达上调参与了慢性心力衰竭的发病过程,并且与心功能受损严重程度密切相关,二者早期联合检测对预测患者不良心血管事件有重要意义。Objective To explore the levels of serum hepatocyte growth factor(HGF)and growth differentiation factor 15(GDF-15)in patients with chronic heart failure and its clinical significance.Methods A total of 107 patients with chronic heart failure,including 36 cases of NYHA class II,41 cases of NYHA class III,and 30 cases of NYHA class IV(according to the NYHA cardiac function classification),and 50 healthy volunteers were randomly selected as controls.The serum HGF and GDF-15 levels were measured by enzyme-linked immunosorbent assay.The left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)were measured by Doppler echocardiography.Predictive value of serum HGF and GDF-15 for poor prognosis in patients with chronic heart failure by receiver operating characteristic curve(ROC)was conducted.Results The serum HGF and GDF-15 levels in patients with chronic heart failure were higher than those in healthy volunteers,and LVESD and LVEDD were higher than those in healthy volunteers,and LVEF was lower than that in healthy volunteers(all P<0.05).With the increase of NYHA classification,the serum HGF and GDF-15 levels gradually increased in patients with chronic heart failure,and LVESD and LVEDD gradually increased,and LVEF gradually decreased(all P<0.05).HGF was positively correlated with LVESD and LVEDD(r=0.672,0.619,both P<0.05),and negatively correlated with LVEF(r=-0.658,P<0.05).GDF-15 was positively correlated with LVESD and LVEDD(r=0.736,0.702,both P<0.05),and negatively correlated with LVEF(r=-0.691,P<0.05).The incidence of adverse cardiovascular events in patients with chronic heart failure during follow-up was 49.53%.The AUC of HGF for predicting adverse cardiovascular events was 0.805,the best cut-off value was 1 008.95 pg/mL,the sensitivity and specificity were 0.73 and 0.82,respectively,and the accuracy was 0.79.The AUC of GDF-15 for predicting adverse cardiovascular events was 0.849,the best cut-off value was 1 226.72 pg/mL,the sensit

关 键 词：心力衰竭 慢性 肝细胞生长因子 生长分化因子-15 

分 类 号：R541.6[医药卫生—心血管疾病]