心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2014年
4期
408-411
,共4页
心力衰竭,充血性%心室重构%纤维化
心力衰竭,充血性%心室重構%纖維化
심력쇠갈,충혈성%심실중구%섬유화
Heart failure,congestive%Ventricular remodeling%Fibrosis
目的：探讨心肌梗死后心力衰竭患者血清生长分化因子-15（GDF-15）水平的变化，及与心功能和心肌纤维化指标的相关性。方法：入选急性心肌梗死后心力衰竭患者100例为心衰组，健康体检者50例为健康对照组。检测并分析两组患者 GDF-15水平的变化，及其与心功能[左心室收缩期内径（LVESd）、舒张末期内径（LVEDd）、左室射血分数（LVEF）]和心肌纤维化相关指标[脑钠肽（BNP）、血清转化生长因子（TGFβ）、I 型前胶原氨基端肽（PINP）和Ⅲ型前胶原氨基端肽（PIIINP）]的相关性。结果：与健康对照组相比，心衰组血清 GDF-15[（623.56±70.21）ng/L 比（2003.53±163.2）ng/L]、TGFβ[（21.5±6.89）ng/ml 比（58.93±12.81）ng/ml]、PINP [（150.58±32.57）ng/ml 比（233.15±26.94）ng/ml]和 PIIINP [（17.56±8.72）ng/ml 比（48.64±9.28）ng/ml]明显升高（P＜0.05～＜0.01）。随着心功能分级的增加（II～IV），GDF-15的水平明显升高[（1521.32±98.23）ng/L 比（2311.92±108.52）ng/L 比（3023.54±129.36）ng/L，P 均＜0.01]。Pearson 相关分析结果显示，心肌梗死后心力衰竭患者血清 GDF-15水平与 LVEF 呈负相关（r＝-0.574，P ＜0.05），与 LVESd 和 LVEDd 呈正相关（r＝0.688，0.752，P 均＜0.05）；GDF-15水平与血浆 BNP，血清 PINP、PIIINP 和 TGFβ水平呈正相关（r＝0.568～0.82，P 均＜0.05）。结论：生长分化因子-15参与心肌梗死后心力衰竭患者的心室重塑。
目的：探討心肌梗死後心力衰竭患者血清生長分化因子-15（GDF-15）水平的變化，及與心功能和心肌纖維化指標的相關性。方法：入選急性心肌梗死後心力衰竭患者100例為心衰組，健康體檢者50例為健康對照組。檢測併分析兩組患者 GDF-15水平的變化，及其與心功能[左心室收縮期內徑（LVESd）、舒張末期內徑（LVEDd）、左室射血分數（LVEF）]和心肌纖維化相關指標[腦鈉肽（BNP）、血清轉化生長因子（TGFβ）、I 型前膠原氨基耑肽（PINP）和Ⅲ型前膠原氨基耑肽（PIIINP）]的相關性。結果：與健康對照組相比，心衰組血清 GDF-15[（623.56±70.21）ng/L 比（2003.53±163.2）ng/L]、TGFβ[（21.5±6.89）ng/ml 比（58.93±12.81）ng/ml]、PINP [（150.58±32.57）ng/ml 比（233.15±26.94）ng/ml]和 PIIINP [（17.56±8.72）ng/ml 比（48.64±9.28）ng/ml]明顯升高（P＜0.05～＜0.01）。隨著心功能分級的增加（II～IV），GDF-15的水平明顯升高[（1521.32±98.23）ng/L 比（2311.92±108.52）ng/L 比（3023.54±129.36）ng/L，P 均＜0.01]。Pearson 相關分析結果顯示，心肌梗死後心力衰竭患者血清 GDF-15水平與 LVEF 呈負相關（r＝-0.574，P ＜0.05），與 LVESd 和 LVEDd 呈正相關（r＝0.688，0.752，P 均＜0.05）；GDF-15水平與血漿 BNP，血清 PINP、PIIINP 和 TGFβ水平呈正相關（r＝0.568～0.82，P 均＜0.05）。結論：生長分化因子-15參與心肌梗死後心力衰竭患者的心室重塑。
목적：탐토심기경사후심력쇠갈환자혈청생장분화인자-15（GDF-15）수평적변화，급여심공능화심기섬유화지표적상관성。방법：입선급성심기경사후심력쇠갈환자100례위심쇠조，건강체검자50례위건강대조조。검측병분석량조환자 GDF-15수평적변화，급기여심공능[좌심실수축기내경（LVESd）、서장말기내경（LVEDd）、좌실사혈분수（LVEF）]화심기섬유화상관지표[뇌납태（BNP）、혈청전화생장인자（TGFβ）、I 형전효원안기단태（PINP）화Ⅲ형전효원안기단태（PIIINP）]적상관성。결과：여건강대조조상비，심쇠조혈청 GDF-15[（623.56±70.21）ng/L 비（2003.53±163.2）ng/L]、TGFβ[（21.5±6.89）ng/ml 비（58.93±12.81）ng/ml]、PINP [（150.58±32.57）ng/ml 비（233.15±26.94）ng/ml]화 PIIINP [（17.56±8.72）ng/ml 비（48.64±9.28）ng/ml]명현승고（P＜0.05～＜0.01）。수착심공능분급적증가（II～IV），GDF-15적수평명현승고[（1521.32±98.23）ng/L 비（2311.92±108.52）ng/L 비（3023.54±129.36）ng/L，P 균＜0.01]。Pearson 상관분석결과현시，심기경사후심력쇠갈환자혈청 GDF-15수평여 LVEF 정부상관（r＝-0.574，P ＜0.05），여 LVESd 화 LVEDd 정정상관（r＝0.688，0.752，P 균＜0.05）；GDF-15수평여혈장 BNP，혈청 PINP、PIIINP 화 TGFβ수평정정상관（r＝0.568～0.82，P 균＜0.05）。결론：생장분화인자-15삼여심기경사후심력쇠갈환자적심실중소。
Objective:To explore change of serum level of growth differentiation factor-15 (GDF-15)in patients with heart failure (HF)after myocardial infarction,and its correlation with cardiac function and myocardial fibrosis indexes.Methods:A total of 100 HF patients after acute myocardial infarction (AMI)were enrolled as HF group,and 50 healthy subjects were selected as healthy control group.GDF-15 level change was measured,its correlation with cardiac function [left ven-tricular end-systolic diameter (LVESd),left ventricular end-diastolic diameter (LVEDd)and left ventricular ejection frac-tion (LVEF)]and relative indexes of myocardial fibrosis [brain natriuretic peptide (BNP),serum transforming growth fac-tor (TGFβ),type I and III procollagen amino-terminal peptides (PINP,PIIINP)]were analyzed in two groups.Results:Compared with healthy control group,there were significant rise in serum levels of GDF-15 [(623.56±70.21)ng/L vs. (2003.53±163.2)ng/L],TGFβ[(21.5±6.89)ng/ml vs.(58.93±12.81)ng/ml],PINP [(150.58±32.57)ng/ml vs. (233.15±26.94)ng/ml]and PIIINP [(17.56±8.72)ng/ml vs.(48.64±9.28)ng/ml]in HF group,P <0.05~<0.01. Along with NYHA cardiac function class increased (II~IV),GDF-15 level significantly elevated [(1521.32±98.23)ng/L vs.(2311.92±108.52)ng/L vs.(3023.54±129.36)ng/L,P <0.01 all].Pearson correlation analysis indicated that in HF patients after myocardial infarction,serum GDF-15 level was inversely correlated with LVEF (r =-0.574,P <0.05), and positively correlated with LVESd and LVEDd (r =0.688,0.752,P <0.05 both);GDF-15 level was positively correla-ted with plasma BNP level,serum levels of PINP,PIIINP and TGFβ(r =0.568~0.82,P <0.05 all).Conclusion:Growth differentiation factor-15 is involved in ventricular remodeling in patients with heart failure after myocardial infarction.
