血清GDF-15、NGAL、HDL-C对心力衰竭预后的预测价值  

Prognostic value of serum GDF⁃15,NGAL and HDL⁃C in patients with heart failure

作　　者：王楚 刘美霞[2] 张莉 谢飞飞 WANG Chu;LIU Meixi;ZHANG Li;XIE Feifei(Emergency Department,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,Chi-na,075000;The Fourth Department of Cardiovascular Medicine,Hebei Provincial People's Hospital,Shijiazhuang,Hebei,China,050051;Department of Cardiology,Hebei Provincial People's Hospital,Shijiazhuang,Hebei,China,050051;Department of Cardiology,Xingtai People's Hospital,Shijiazhuang,Hebei,China,050051)

机构地区：[1]河北北方学院附属第一医院急诊科,河北张家口075000 [2]河北省人民医院心血管内四科,河北石家庄050051 [3]邢台市人民医院心脏内五科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2023年第6期1003-1006,1011,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生厅科研基金项目(20190025)。

摘　　要：目的探讨血清生长分化因子-15(GDF-15)、中性粒细胞明胶酶相关脂蛋白(NGAL)、高密度脂蛋白胆固醇(HDL-C)对心力衰竭预后的预测价值。方法选取2019年7月至2021年8月于河北省人民医院心血管内科就诊并住院的109例患者作为研究对象,按照患者是否发生主要不良心血管事件(MACE)将患者分为MACE组(n=28)和非MACE组(n=81)。比较两组患者的一般资料以及血清GDF-15、NGAL、HDL-C水平。采用多因素Logistic回归分析心力衰竭预后的独立影响因素。并采用受试者工作(ROC)曲线检测血清GDF-15、NGAL、HDL-C对心力衰竭预后的预测价值。结果NMACE组的美国纽约心脏疾病协会(NYHA)分级为Ⅲ-Ⅳ级的病例数、稳定性冠心病发病率、血清NT-proBNP、GDF-15、NGAL水平均明显低于MACE组,且HDL-C水平明显高于MACE组,差异具有统计学意义(χ^(2)=9.352、12.042,t=5.297、3.158、21.618、11.176,P<0.05)。多因素Logistic回归分析结果显示,NYHA分级为Ⅲ~Ⅳ级、血清NT-proBNP、GDF-15、NGAL、HDL-C水平均为影响心力衰竭患者预后的独立影响因素(P<0.05)。ROC曲线结果显示,血清GDF-15、NGAL、HDL-C单独检测以及三者联合检测预测心力衰竭患者预后的曲线下面积(AUC)为0.876、0.834、0.843、0.910。结论血清GDF-15、NGAL、HDL-C对心力衰竭预后不良具有一定的预测价值,且三者联合检测对心力衰竭患者预后不良的预测具有更高的价值,可以为临床评估心力衰竭患者预后不良提供参考。Objective To investigate the prognostic value of serum growth differentiation factor⁃15(GDF⁃15),neutrophil gelatinase related lipoprotein(NGAL)and high⁃density lipoprotein cholesterol(HDL⁃C)in patients with heart failure.Methods 109 patients who were hospitalized in the Cardiovascular Depart⁃ment of Hebei People's Hospital from July 2019 to August 2021 were selected as the study subjects.The patients were divided into the MACE group(n=28)and the NMACE group(n=81)according to whether they had ma⁃jor adverse cardiovascular events(MACE).The general data and serum levels of GDF⁃15,NGAL and HDL⁃C were compared between the two groups.Multivariate Logistic regression was used to analyze the independent factors influencing the prognosis of heart failure.The predictive value of serum GDF⁃15,NGAL,HDL⁃C on the prognosis of heart failure was detected by the ROC curve.Results The number of cases classified asⅢ~Ⅳby NYHA in the NMACE group,the incidence rate of stable coronary heart disease,the levels of NT proBNP,GDF⁃15,NGAL in serum were significantly lower than those in the MACE group,and the level of HDL⁃C was significantly higher than that in the MACE group(χ^(2)=9.352,12.042,t=5.297,3.158,21.618,11.176,P<0.05).Multivariate logistic regression analysis showed that NYHA gradeⅢ~Ⅳ,serum NT proBNP,GDF⁃15,NGAL,HDL⁃C were independent factors affecting the prognosis of patients with heart failure(P<0.05).The ROC curve results showed that the area under the curve(AUC)of serum GDF⁃15,NGAL,HDL⁃C alone and jointly to predict the prognosis of patients with heart failure was 0.876,0.834,0.843,0.910.Conclusion Se⁃rum GDF⁃15,NGAL and HDL⁃C have a certain predictive value for poor prognosis of heart failure,and their combined detection has a higher predictive value for poor prognosis of heart failure patients,which can provide a reference for clinical evaluation of poor prognosis of heart failure patients.

关 键 词：血清生长分化因子-15 中性粒细胞明胶酶相关脂蛋白 高密度脂蛋白胆固醇 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]