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中国临床研究:2025,38(9):1421-1424,1429
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血清生长分化因子-15和脑钠肽及脂联素在预测急性心肌梗死患者预后中的价值
(1.新疆维吾尔自治区人民医院心内科,新疆 乌鲁木齐 830001;2.新疆维吾尔自治区人民医院呼吸与危重症医学中心,新疆 乌鲁木齐 830001)
Prognostic value of serum growth differentiation factor-15, brain natriuretic peptide and adiponectin in patients with acute myocardial infarction
(1.Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China;2.Respiratory and Critical Care Medicine Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830001, China)
摘要
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投稿时间:2024-10-21   网络发布日期:2025-09-19
中文摘要: 目的 探讨急性心肌梗死(AMI)患者血清生长分化因子-15(GDF-15)、脑钠肽(BNP)、脂联素(APN)表达水平及其对预后的评估价值。方法 收集新疆维吾尔自治区人民医院2020年8月至2023年9月收治的AMI患者资料100例。根据入院时全球急性冠脉事件注册(GRACE)评分将患者分为低危组(≤108分,n=31)、中危组(109~140分,n=49)、高危组(>140分,n=20)。根据出院后随访6个月患者是否发生主要心血管不良事件(MACE)分为预后良好组(n=66)和预后不良组(n=34)。比较不同病情程度、不同预后患者血清GDF-15、BNP、APN表达水平;采用Pearson相关性分析血清GDF-15、BNP、APN与患者病情危急程度的关系;多因素logistic回归分析AMI患者发生MACE的相关影响因素;绘制受试者工作特征(ROC)曲线分析血清GDF-15、BNP、APN对AMI患者预后的预测价值。结果 与预后良好组相比,预后不良组患者低密度脂蛋白胆固醇(LDL-C)(t= 4.457,P<0.01)、GDF-15(t= 5.143,P<0.01)、BNP(t= 5.437,P<0.01)水平较低,差异有统计学意义。预后不良组白细胞计数(WBC)(t= 2.033,P= 0.045)、APN水平(t= 5.891,P<0.01)低于预后良好组,差异有统计学意义。随患者病情程度加重,血清GDF-15、BNP水平上升,APN水平下降(F=14.101、70.534、31.011,P<0.05)。血清GDF-15、BNP与GRACE评分正相关(r=0.618、0.672,P<0.05),APN水平与GRACE评分负相关(r=-0.724,P<0.05)。高水平LDL-C、GDF-15、BNP均是MACE发生的危险因素,高水平APN是保护因素(P<0.05)。GDF-15、BNP、APN联合检测以预测AMI患者预后的ROC曲线下面积(AUC)为0.896,大于GDF-15(0.785)、BNP(0.779)、APN(0.845)单独检测。结论 血清GDF-15、BNP、APN在AMI患者中的水平对临床评估患者病情及预后具有一定参考价值。
Abstract:Objective To investigate the expression levels of serum growth differentiation factor-15 (GDF-15), brain natriuretic peptide (BNP), and adiponectin (APN) in patients with acute myocardial infarction (AMI) and their prognostic evaluation value. Methods A total of 100 AMI patients treated at the People’s Hospital of Xinjiang Uygur Autonomous Region from August 2020 to September 2023 were included. According to the Global Registry of Acute Coronary Events (GRACE) score at admission, patients were divided into low-risk group (≤108 points, n=31), intermediate-risk group (109-140 points, n=49), and high-risk group (>140 points, n=20). Based on the occurrence of major adverse cardiovascular events (MACE) within 6 months after discharge, patients were divided into the good prognosis group (n=66) and poor prognosis group (n=34). The serum levels of GDF-15, BNP, and APN were compared among patients with different severity levels and prognoses. Pearson correlation analysis was used to examine the relationship between serum GDF-15, BNP, APN, and the severity of the patients’ condition. Multivariate logistic regression was applied to analyze the factors associated with the occurrence of MACE in AMI patients. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of serum GDF-15, BNP, and APN for the prognosis of AMI patients. Results Compared with the good prognosis group, the poor prognosis group had lower levels of low-density lipoprotein cholesterol (LDL-C) (t= 4.457, P<0.01), GDF-15 (t= 5.143, P<0.01), and BNP (t= 5.437, P<0.01), with statistically significant differences. The poor prognosis group had lower white blood cell count (WBC) (t= 2.033, P= 0.045) and APN levels (t= 5.891, P<0.01) than the good prognosis group, with statistically significant differences. As the severity of the condition worsened, serum GDF-15 and BNP levels increased, while APN levels decreased (F=14.101, 70.534, 31.011, P<0.05). Serum GDF-15 and BNP were positively correlated with the GRACE score (r=0.618, 0.672, P<0.05), and APN levels were negatively correlated with the GRACE score (r=-0.724, P<0.05). High levels of LDL-C, GDF-15, and BNP were identified as risk factors for the occurrence of MACE, while high levels of APN were protective factors (P<0.05). The combined detection of GDF-15, BNP, and APN for predicting the prognosis of AMI patients had an area under curve (AUC) of 0.896, which was higher than that for GDF-15 (0.785), BNP (0.779), and APN (0.845) individually. Conclusion The levels of serum GDF-15, BNP, and APN in AMI patients have certain reference value for clinical evaluation of the patients’ condition and prognosis.
文章编号:     中图分类号:R542.2    文献标志码:A
基金项目:新疆维吾尔自治区科技计划项目(2022D01C153)
附件
引用文本:
谷佩佩,汪海涛,魏肖慧.血清生长分化因子-15和脑钠肽及脂联素在预测急性心肌梗死患者预后中的价值[J].中国临床研究,2025,38(9):1421-1424,1429.

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