急性心肌梗死患者血清GDF-15的水平变化及其临床意义

摘要

目的：探讨急性心肌梗死（AMI）患者血清生长分化因子-15（GDF-15）的水平变化及其临床意义。方法选取2014年2月～2015年2月于陕西省汉中市中心医院急诊科治疗的AMI患者127例（观察组），年龄51～82岁，其中ST段抬高型心肌梗死患者74例（STEMI组），非ST段抬高型心肌梗死患者53例（NSTEMI组），同时选取在陕西省汉中市中心医院体检的健康人群104例作为健康对照组。检测各组血清GDF-15、肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I（cTnI）、肌红蛋白（Mb）及左室重构指数（LVRI）。结果 AMI组血清GDF-15为（3.04±1.09）g/L，明显高于健康对照组（P＜0.05）；AMI组中STEMI患者血清GDF-15为（3.30±1.10）g/L，明显高于NSTEMI患者（P＜0.05）；AMI组cTnI、CK-MB和Mb分别为（3.82±1.53）g/L、（45.07±13.16）g/L和（201.11±45.62）g/L，明显高于健康对照组（P均＜0.05）；AMI组中STEMI患者cTnI、CK-MB和Mb分别为（4.07±1.37）g/L、（48.13±17.49） g/L和（210.07±34.27）g/L，明显高于NSTEMI患者，差异有统计学意义（P均＜0.05）；血清GDF-15与CK-MB、cTnI、Mb呈正相关（r=0.427、0.409、0.511，P＜0.05）；GDF-15与LVRI变化率呈正相关（r偏=0.303，P＜0.05），而CK-MB、cTnI、Mb与LVRI变化率无相关性（P均＞0.05）。结论 AMI患者血清GDF-15、cTnI、CK-MB和Mb均升高，而STEMI患者升高明显，GDF-15与cTnI、CK-MB和Mb相关，同时与LVRI相关，GDF-15在AMI诊断中有一定的价值。%Objective To investigate the change of plasma growth differentiation factor-15 (GDF-15) level and its clinical significance in patients with acute myocardial infarction (AMI).Methods From February 2014 to February 2015, 127 patients (observation group) treated in Hanzhong Central Hospital were selected (age from 51 to 82 years old). 74 cases were ST segment elevation myocardial infarction patients (STEMI group), and 53 cases were non ST segment elevation myocardial infarction patients (NSTEMI group). 104 healthy people in the same hospital were selected as healthy controls. Plasma GDF-15, myocardial infarction three indicators [isoenzyme of creatine kinase (CK-MB), troponin I (cTnI), myoglobin (MB) and left ventricular remodeling index (LVRI) were tested in all groups.Results Plasma GDF-15 in AMI group was (3.04±1.09) g/L, which is significantly higher than the control group (P<0.05). Plasma GDF-15 in STEMI group was (3.30±1.10) g/L, which is significantly higher than NSTEMI group (P<0.05). The cTnI, CK-MB and Mb were (3.82±1.53) g/L, (45.07±13.16) g/L and (201.11±45.62) g/L in AMI group, which were significantly higher than the control group (P<0.05). The cTnI, CK-MB and Mb were (4.07±1.37) g/L, (48.13±17.49)g/L and (210.07±34.27) g/L in STEMI group, which were significantly higher than NSTEMI patients (P<0.05). Plasma GDF-15 was positively correlated with CK-MB, cTnI and Mb (r=0.427, 0.409, 0.511,P<0.05); and GDF-15 was positively correlated with change rate of LVRI (r=0.303,P<0.05). However, there was no correlation between CK-MB, cTnI, Mb and change rate of LVRI (P>0.05).Conclusion Plasma GDF-15, cTnI, CK-MB and Mb in AMI patients were increased, and especially in STEMI patients. GDF-15 is associated with cTnI, CK-MB and Mb, and is associated with LVRI. GDF-15 has certain value in AMI diagnosis.