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目的探讨血清生长分化因子15(GDF-15)与冠心病患者冠状动脉病变严重程度和预后的关系。方法行冠状动脉造影确诊为冠心病的患者118例分成三组:A组37例,单支病变;B组42例,两支病变;C组39例,多支病变。采用ELISA法测定各组手术前血清GDF-15水平,出院后第6、12和24个月电话随访患者主要心血管事件(MACE)的发生情况。结果血清GDF-15水平随病变严重程度加重而升高(P<0.01)。随访期间,A组无MACE发生,C组MACE发生率15.3%,高于B组的4.7%(P<0.01)。C组患者GDF-15高表达是其随访期内发生MACE的危险因素(OR=1.011,P=0.018)。结论血清GDF-15水平升高提示冠心病患者冠状动脉的病变程度较重,提示预后较差。
Objective To investigate the relationship between the serum level of differentiation factor 15 (GDF-15) and the severity of coronary artery disease and its prognosis in patients with coronary heart disease. Methods One hundred and fourty-eight patients with coronary heart disease diagnosed by coronary angiography were divided into three groups: group A (n = 37) with single vessel disease; group B (n = 42) with two vessels; group C (n = 39) with multiple vessels. Serum levels of GDF-15 in each group were measured by ELISA. The occurrence of major cardiovascular events (MACE) in telephone follow-up patients at 6, 12 and 24 months after discharge. Results Serum GDF-15 levels increased with the severity of the disease (P <0.01). During follow-up, there was no MACE in group A, and the incidence of MACE in group C was 15.3%, higher than that in group B (4.7%, P <0.01). The high expression of GDF-15 in group C was the risk factor of MACE during follow-up (OR = 1.011, P = 0.018). Conclusions Elevated serum levels of GDF-15 suggest that coronary artery disease is more severe in patients with coronary heart disease, suggesting that the prognosis is poor.