血清GDF-15及sST2可诊断急性一氧化碳中毒患者发生心肌损伤  

Serum GDF-15 and sST2 can diagnose the occurrence of myocardial injury in patients with acute carbon monoxide poisoning

作　　者：潘婧[1] 胡威[1] PAN Jing;HU Wei(Department of Emergency Medicine,Xiaogan Central Hospital,Hubei Xiaogan,432003,China)

机构地区：[1]孝感市中心医院急诊内科,湖北孝感432003

出　　处：《内科急危重症杂志》2024年第6期524-527,共4页Journal of Critical Care In Internal Medicine

基　　金：孝感市科学技术局资助项目(XGKJ2020010005)。

摘　　要：目的:探究血清生长分化因子-15(GDF-15)、可溶性生长刺激表达基因2(sST2)对急性一氧化碳中毒(ACOP)患者心肌损伤的诊断价值。方法:选取82例ACOP住院患者为研究对象,根据患者入院后3h肌钙蛋白I(cTnI)水平分为心肌损伤组(33例)和无心肌损伤组(49例),采集所有患者入院时的空腹静脉血,用酶联免疫吸附法(ELISA)检测2组血清GDF-15及sST2水平;全自动生化分析仪检测心肌酶[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]水平,比较组间差异。采用Pearson法分析血清GDF-15及sST2与心肌酶水平的相关性,受试者工作特征(ROC)曲线分析血清GDF-15及sST2对ACOP患者发生心肌损伤的诊断价值;Logistic回归分析ACOP患者发生心肌损伤的影响因素。结果:心肌损伤组有吸烟史患者的比例及血清GDF-15、sST2、CK、CK-MB水平显著高于无心肌损伤组(P均<0.05);Pearson相关分析显示,ACOP患者血清GDF-15、sST2水平与CK、CK-MB水平呈正相关(P均<0.05);血清GDF-15、sST2水平单独诊断及其两者联合诊断ACOP患者发生心肌损伤的曲线下面积(AUC)分别为0.854、0.885、0.945。Logistic分析显示,血清GDF-15、sST2、CK、CK-MB水平及有吸烟史是ACOP患者发生心肌损伤的影响因素(P均<0.05)。结论:血清GDF-15、sST2水平在ACOP心肌损伤患者中明显升高,且为ACOP患者并发心肌损伤的独立影响因素,二者联合检测对ACOP患者发生心肌损伤的诊断价值较高。Objective:To investigate the diagnostic value of serum growth differentiation factor-15(GDF-15)and soluble growth stimulating gene 2(sST2)for myocardial injury in patients with acute carbon monoxide poisoning(ACOP).Methods:Totally,82 hospitalized patients with ACOP were selected as the research subjects,and were divided into myocardial injury group(33 cases)and non-myocardial injury group(49 cases)based on their cTnl levels at 3 h after admission.The fasting venous blood was collected from all patients upon admission,and enzyme-linked immunosorbent assay(ELISA)was used to detect serum GDF-15 and sST2 levels in two groups.The fully automated biochemical analyzer was used to detect the levels of myocardial enzymes[creatine kinase(CK),creatine kinase isoenzyme(CK-MB)]and the differences between groups were compared.The Pearson method was used to analyze the correlation between serum GDF-15,sST2 and myocardial enzyme levels.Receiver operating characteristic(ROC)curve was used to analyze serum GDF-15 and sST2 for the diagnostic value of myocardial injury in ACOP patients.Logistic regression analysis was used to evaluate the influencing factors of myocardial injury in ACOP patients.Results:The proportion of patients with a history of smoking and the levels of serum GDF-15,sST2,CK,and CK-MB in the myocardial injury group were significantly higher than those in the non-myocardial injury group(all P<0.05).Pearson correlation analysis showed that serum GDF-15 and sST2 levels in ACOP patients were positively correlated with CK and CK-MB levels(all P<0.05).The areas under the curve(AUC)of serum GDF-15,sST2 levels,and their combined diagnosis of ACOP patients with myocardial injury were 0.854,0.885,and 0.945,respectively.Logistic analysis showed that serum GDF-15,SST2,CK,CK-MB levels,and smoking history were influencing factors for myocardial injury in ACOP patients(P<0.05).Conclusion:Serum GDF-15 and sST2 levels are significantly elevated in patients with ACOP myocardial injury,and are independent influencing factors for the

关 键 词：血清生长分化因子-15 可溶性生长刺激表达基因2 急性一氧化碳中毒 心肌损伤 

分 类 号：R595.1[医药卫生—内科学]