GDF-15、sST2及cTnI在急性心肌梗死患者中的表达及其对预后的预测价值研究  

Expression Levels of GDF-15,sST2 and cTnI in Patients with Acute Myocardial Infarction and Its Predictive Value for Prognosis

作　　者：党璋 吴琼 王娟[3] 王颖 DANG Zhang;WU Qiong;WANG Juan;WANG Ying(Department of Emergency Ward,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China;Department of General Neonatology,Children's Hospital of Capital Institute of Pediatrics,Beijing 100020,China;Department of Neurosurgery,Youanmen Hospital of Fengtai District,Beijing 100069,China;Outpatient Department of General Practice,Xinjiekou Community Health Service Center,Beijing 100016,China)

机构地区：[1]首都医科大学附属北京世纪坛医院急诊病房,北京100038 [2]首都儿科研究所附属儿童医院普通新生儿外科,北京100020 [3]北京丰台右安门医院神经外科,北京100069 [4]北京市西城区新街口社区卫生服务中心全科门诊,北京100016

出　　处：《临床误诊误治》2021年第2期49-53,共5页Clinical Misdiagnosis & Mistherapy

基　　金：北京市自然科学基金资助项目(Z161100000516006)。

摘　　要：目的分析血清分化生长因子-15(GDF-15)、血清可溶性ST2(sST2)及心肌肌钙蛋白I(cTnI)在急性心肌梗死(acute myocardial infarction,AMI)患者中的表达及其对预后的预测价值。方法选取2018年4月—2019年4月本院收治的57例AMI作为观察组,根据随访是否发生主要心血管不良事件(major adverse cardiovascular events,MACE)分为MACE组(n=25)和无MACE组(n=32)。另选取同期52例于本院接受健康体检结果正常者作为对照组。收集所有研究对象临床资料,比较GDF-15、sST2及cTnI在各组间的水平;采用受试者工作特征(eceiver operator characteristic,ROC)曲线分析GDF-15、sST2、cTnI及三者联合检测对AMI患者近期预后的预测价值,并采用Logistic回归分析探讨AMI预后不良的影响因素。结果观察组GDF-15、sST2及cTnI水平均高于对照组(P<0.01)。MACE组GDF-15、sST2及cTnI水平均高于无MACE组(P<0.01)。ROC曲线分析显示,GDF-15、sST2、cTnI联合检测对AMI患者近期预后的预测价值最佳。多因素Logistic回归分析显示,发病至治疗时间长、大面积梗死及GDF-15、sST2、cTnI表达异常为AMI患者预后不良的独立危险因素(P<0.05或P<0.01)。结论AMI患者GDF-15、sST2及cTnI水平高于正常人群;GDF-15、sST2及cTnI为影响AMI患者预后不良的独立危险因素,其联合检测可作为预测患者预后有效指标。Objective To analyze the expression levels of growth differentiation factor-15(GDF-15),soluble ST2(sST2)and cardiac troponin I(cTn I)in patients with acute myocardial infarction(AMI)and its predictive value for prognosis.Methods A total of 57 AMI patients admitted to this hospital from April 2018 to April 2019 were selected as the observation group.According to presence or absence of major adverse cardiovascular events(MACE)during follow-up,they were divided into MACE group(n=25)and non-MACE group(n=32).Another 52 healthy patients who received health examination in this hospital during the same period were selected as the control group.The clinical data of all study subjects were collected,and the expression levels of GDF-15,sST2 and cTnI were compared between the groups.Receiver operator characteristic(ROC)curve was used to analyze the predictive value of GDF-15,sST2,cTnI and the combined detection of them for the short-term prognosis of AMI patients.Logistic regression was used to analyze the risk factors affecting the poor prognosis of AMI patients.Results The expression levels of GDF-15,sST2 and cTnI in the observation group were higher than those in the control group(P<0.01).The expression levels of GDF-15,sST2 and cTnI in MACE group were higher than those in MACE group(P<0.01).ROC curve analysis showed that the combined detection of GDF-15,sST2,and cTnI had the optimal predictive value for the short-term prognosis of AMI patients.Multivariate logistic regression analysis indicated that the time interval between onset and treatment,large-area infarction,and abnormal expression of GDF-15,sST2,and cTnI were independent risk factors affecting the poor prognosis of AMI patients(P<0.05 or P<0.01).Conclusion The expression levels of GDF-15,sST2 and cTnI in AMI patients are higher than those in the healthy people.GDF-15,sST2 and cTnI are independent risk factors that affect the poor prognosis of AMI patients,and the combined detection of the three can be used as an effective indicator to predict the poor prognosis

关 键 词：心肌梗死 分化生长因子-15 血清可溶性ST2 肌钙蛋白I 预后 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]