老年急性冠脉综合征患者血清生长分化因子-15水平与冠状动脉病变程度及预后的相关性

Baoliang Guo, Zhanlu Li
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摘要

目的分析生长分化因子-15(GDF-15)水平与冠状动脉疾病严重程度、预后及老年急性冠状动脉综合征患者的相关性。方法对2017年3月至2018年4月入住杭州西溪医院和浙江大学医学院附属邵逸夫医院的168例老年急性冠状动脉综合征患者进行研究。将患者分为三组:GDF-15>1800μmol/L(n=28)、GDF-15<1200-1800μmol/L(n=45)和GDF-15<200μmol/L(n=95)。分析并比较各组之间的血浆高敏C反应蛋白(hs-CRP)和GDF-15水平、SYNTAX评分、单血管、双血管、多血管冠状动脉疾病和主要心血管不良事件(MACE)。结果三组患者血浆hs-CRP、GDF-15水平差异有统计学意义(P<0.05),SYNTAX评分、单支、双支、多支冠状动脉病变及MACE三组患者均有统计学意义(P<0.05),SYNTAX评分(OR=1.948,95%CI:1.097~2.098)、双血管病变(OR=1.124,95%CI:1.006~1.251)和多血管病变(OR=1.744,95%CI:1.149~2.642)(均P<0.05)是影响预后的有统计学意义的因素。结论GDF-15水平与SYNTAX评分、双血管病变和多血管病变相关,可预测急性冠状动脉综合征患者冠状动脉病变的严重程度和预后。关键词:急性冠状动脉综合征;生长分化因子;预后
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Correlation of serum growth differentiation factor-15 level with degree of coronary artery lesion and prognosis in elderly patients with acute coronary syndrome
Objective To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome. Methods A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups: GDF-15>1 800 μmol/L(n=28), GDF-15 between 1 200-1 800 μmol/L(n=45), and GDF-15<1 200 μmol/L(n=95). Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15, and SYNTAX score, single-vessel-, double-vessel, multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups. Results Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05). There were significant statistically differences in SYNTAX score, single-vessel, double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05). Logistic regression analysis showed that the levels of GDF-15(OR=2.092, 95%CI: 1.585~2.687), SYNTAX score(OR=1.948, 95%CI: 1.097~2.098), double-vessel lesions(OR=1.124, 95%CI: 1.006~1.251)and multi-vessel lesions(OR=1.744, 95%CI: 1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis. Conclusions GDF-15 level is correlated with SYNTAX score, double-vessel lesions and multi-vessel lesions, and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome. Key words: Acute coronary syndrome; Growth differentiation factors; Prognosis
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