生长分化因子-15与急诊冠状动脉介入治疗术后患者左心室内径及舒张功能变化的相关性分析Growth differentiation factor 15 as predictor of left ventricular dimension and diastolic function improvement in patients with primary percutaneous intervention after ST elevation myocardial infarction
徐昕晔,聂颖,梁瀛,郑凌冰,米琳,于海奕,高炜
摘要(Abstract):
目的前期研究发现生长分化因子15(growth-differentiation factor-15,GDF-15)与左室内径变化以及心肌缺血/再灌注损伤密切相关,旨在探讨GDF-15与接受急诊冠状动脉介入治疗的ST段抬高型心肌梗死(STEMI)患者远期左室内径及舒张功能变化的相关性。方法连续入选因STEMI于北京大学第三医院接受急诊冠状动脉介入治疗的患者87例,介入治疗前检测GDF-15水平,并于入院后完善基线超声心动图检查。出院后定期门诊随访和冠心病二级预防。平均随访时间18个月,复查超声心动图,分别计算左心室舒张末内径(LVEDD)和二尖瓣E峰速度与二尖瓣环舒张早期峰值速度比值(E/Em)的变化率。统计分析基线GDF-15与心室重构的相关性。结果患者的平均GDF-15水平为(986.48±322.99)pg/ml。超声心动图检查显示随访患者LVEDD较基线平均增加(2.68±8.82)%,E/Em较基线平均增加了(4.51±33.50)%。GDF-15与LVEDD变化率存在负相关(r=-0.514,P<0.01),与E/Em变化率存在负相关(r=-0.501,P<0.01)。以964.67pg/ml作为界值,GDF-15预测LVEDD改善趋势的敏感性为77.4%,特异性为67.9%;预测E/Em改善趋势的敏感性为76.5%,特异性为69.8%。结论 GDF-15水平可能部分预测早期完全再血管化的STEMI患者远期LVEDD及舒张功能的改善趋势。
关键词(KeyWords): 细胞因子类;心肌梗死;心室重构;心室功能
基金项目(Foundation): “985”项目(PUCRP-004)
作者(Author): 徐昕晔,聂颖,梁瀛,郑凌冰,米琳,于海奕,高炜
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