CAJ | 학술논문

目的：探讨生长分化因子-15（GDF-15）水平与ST段抬高型心肌梗死（STEMI）急诊经皮冠状动脉介入治疗（PCI）术后半年左室重构（ LVR）程度的相关性，并评价其对LVR的预测价值。方法选择STEMI急诊PCI术后患者63例，入院24h内采集静脉血，测定血清N末端B型脑钠肽前体（ NT-proBNP），并留取血清标本，集中检测GDF-15表达水平。于入院后96h内及随访末（6个月）行超声心动图检测，左室重构定义为左室舒张末期容积较基线增加＞20％，据此将患者分成左室重构（ LVR）组（ n＝13）及非左室重构（NLVR）组（n＝50），分析两组入院24h内血清GDF-15表达水平与STEMI急诊PCI术后晚期左室重构的相关性。结果13例（20．63％）患者发生了左室重构，LVR组血清GDF-15水平显著高于NLVR组（P＜0．01）。 Logistic回归分析示GDF-15水平与LVR正相关（OR 1．006，P＜0．01）。 ROC曲线分析结果示：GDF-15曲线下面积（AUC）为0．763（95％置信区间0．623～0．903）。结论 STEMI急诊PCI术后患者血清GDF-15水平与LVR呈独立、显著的正相关。
목적：탐토생장분화인자-15（GDF-15）수평여ST단태고형심기경사（STEMI）급진경피관상동맥개입치료（PCI）술후반년좌실중구（ LVR）정도적상관성，병평개기대LVR적예측개치。방법선택STEMI급진PCI술후환자63례，입원24h내채집정맥혈，측정혈청N말단B형뇌납태전체（ NT-proBNP），병류취혈청표본，집중검측GDF-15표체수평。우입원후96h내급수방말（6개월）행초성심동도검측，좌실중구정의위좌실서장말기용적교기선증가＞20％，거차장환자분성좌실중구（ LVR）조（ n＝13）급비좌실중구（NLVR）조（n＝50），분석량조입원24h내혈청GDF-15표체수평여STEMI급진PCI술후만기좌실중구적상관성。결과13례（20．63％）환자발생료좌실중구，LVR조혈청GDF-15수평현저고우NLVR조（P＜0．01）。 Logistic회귀분석시GDF-15수평여LVR정상관（OR 1．006，P＜0．01）。 ROC곡선분석결과시：GDF-15곡선하면적（AUC）위0．763（95％치신구간0．623～0．903）。결론 STEMI급진PCI술후환자혈청GDF-15수평여LVR정독립、현저적정상관。
[ ABSTRACT] Objective To investigate the correlation between the level of GDF-15 and left ventricular remodeling in STEMI pa-tients treated with emergency PCI for 6 months.And to evaluate its predictive value of LVR.Methods Sixty-three patients with STEMI un-dergoing primary percutaneous coronary intervention( PCI) were selected to the study.Blood samples for the determination of GDF-15 and N-terminal pro brain natriuretic peptide( NT-proBNP) were obtained within the first 24 hours after symptom onset.Echocardiography was per-formed in all patients within the first 96 hours of admission and at 6 months of follow-up.LVR was defined as a >20% increase in the left ventricular end-diastolic volume at 6 months of follow-up compared to the baseline,which was divided into left ventricular remodeling( LVR) group(n=13) and non left ventricular remodeling(NLVR) group(n=50).The correlation of GDF-15 and LVR between the two groups were analyzed within the first 24 hours.Results Left ventricular remodeling occurred in 13 patients(20.63%).The serum GDF-15 level in LVR group was significantly higher than that in NLVR group(P<0.01).Logistic regression analysis showed that the level of GDF-15 was positive-ly correlated with LVR(OR 1.006,P<0.01).ROC curve analysis showed that the area under the GDF-15 curve(AUC) was 0.763(95%confidence interval 0.623~0.903).Conclusion GDF-15 level and LVR in patients with STEMI after emergency PCI are independently and significantly positive correlation.