急性心肌梗死患者血清生长分化因子15、肌钙蛋白及脑钠肽的表达及其临床意义

目的:探讨血清生长分化因子15(GDF-15)和肌钙蛋白I(cTnI)、脑钠肽(BNP)在急性心肌梗死(AMI)患者中的关系及对其近期预后的预测价值。方法:选择因胸痛(发病时间<12h)入院诊断为AMI患者122例为研究对象,冠状动脉造影正常者40例为对照组。采用ELISA法测定GDF-15及BNP浓度,采用免疫荧光定量技术测定cTnI浓度。记录患者住院和平均随访12个月期间的心血管事件(心血管死亡、心力衰竭、再发心绞痛或再发心肌梗死)的发生情况。结果:AMI组GDF-15与BNP和cTnI浓度呈正相关;发生心血管事件组GDF-15水平高于未发生心血管事件组;多变量logistic逐步回归表明GDF-15是预测近期心血管事件的危险因素(OR=0.79,95%CI:0.67～0.84,P<0.05)。结论:GDF-15与BNP和cTnI浓度呈正相关,GDF-15水平是预测近期心血管事件的有效指标之一。

Serum levels of growth differentiation factor 15 and BNP in patients with acute myocardial infarction and their clinical significance

0bjective To explore the correlation between growth differentiation factor 15(GDF-15),cardiac troponin I(cTnI) and brain natriuretic peptide(BNP) in patients with acute myocardial infarction(AMI) and the short-term prognosis value of GDF-15.Methods We selected 122 subjects who had acute myocardial infarction with onset < 12 h,with follow-up average 12 months and 40 normal coronary angiography(CAG) were set as control group.The serum GDF-15 and BNP were measured by enzyme-linked immunosorbent assay(ELISA);The serum cTnI were measured by immunofluorometric assay technique.The clinical main adverse cardiac events(MACE) including cardiac death,heart failure,myocardial infarction or recurrent angina pectoris were recorded during hospitalization and follow-up.Results Compared with control subjects,level of GDF-15 and BNP were higher in patients with AMI including ST-elevation myocardial infarction(STEMI) and No ST-elevation myocardial infarction(NSTEMI)(P < 0.05).Positive correlations between GDF-15,cTnI and BNP were observed by Spearman correlations analysis.In the AMI patients,GDF-15 level was elevated in patients with MACE compared with patients without MACE.Multivariate logistic regression analysis revealed that the GDF-15 level was independently associated with MACE during average 12 months(odds ratio = 0.79,95% CI:0.67 ～ 0.84,P < 0.05).Conclusions There is positive correlation between the level of GDF-15,cTnI and BNP.of patients with AMI.The serum level of GDF-15 is associated with short-term prognosis in patients with AMI.