GDF-15评估急性心力衰竭患者预后的临床价值被引量：6

Value of GDF-15 in predicting prognosis of patients with acute heart failure

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摘要目的:探讨生长分化因子-15(GDF-15)在预测急性心力衰竭(心衰)患者长期预后中的临床价值。方法:纳入2012-04-2016-05因急性心衰发作入住我院的患者279例,进行为期1年的随访,定义终点事件为全因死亡,检测这些患者基线血样中GDF-15浓度,分析其对急性心衰长期预后的影响。结果:1年内死亡组与生存组的GDF-15水平存在显著差异(P<0.001)。ROC曲线显示,曲线下面积(AUC)为0.692,最佳预测值为4 526.0ng/L,敏感性为53.1%,特异性为80.9%。Kaplan-Meier生存曲线发现,GDF-15>4 526.0ng/L的高水平组全因死亡率明显升高(P<0.001),约为低水平组的3倍。Cox比例风险回归(向前逐步)模型提示,GDF-15为急性心衰患者1年终点事件的独立预测因子(HR:1.554,P=0.018)。结论:GDF-15用于评估急性心衰预后具有一定的临床价值。 Objective：To investigate the clinical value of growth differentiation factor-15（GDF-15）in longterm prognosis of patients with acute heart failure（AHF）.Method：A total of 279 patients admitted to our hospital for AHF from 2012-04 to 2016-05 were enrolled and were followed up for one year.The primary endpoint event was defined as all-cause mortality.Measuring the concentration of GDF-15 in baseline blood samples obtained from these patients to analyze its effect on long-term prognosis of AHF.Result：There was a significant difference in GDF-15 levels between the death group and the survival group within one year（P〈0.001）.The ROC curve showed that the area under the curve（AUC）of GDF-15 was 0.692,the optimal cut off point was 4 526.0 ng/L,and sensitivity was 53.1%,specificity was 80.9%.The Kaplan-Meier survival curve found that the all-cause mortality rate in the group with GDF-15 〉4 526.0 ng/L was significantly higher（P〈0.001）,which was about three times that in the low-level group.The Cox proportional hazards regression（forward stepwise）model showed that GDF-15 was an independent predictor of 1-year endpoint events in patients with AHF（HR：1.554,P=0.018）.Conclusion：GDF-15 has certain clinical value for evaluating the prognosis of AHF.

作者张丽王凯祝绪郑旭辉倪葛慧程慧玲王慧敏吴倩芸姚文明周芳周艳丽张海锋李新立 ZHANG Li;WANG Kai;ZHU Xu;ZHENG Xuhui;NI Gehui;CHENG Huiling;WANG Huimin;WU Qianyun;YAO Wenming;ZHOUFang;ZHOUYanli;ZHANG Haifeng;LI Xinli(Department of Cardiology,the First Affiliated Hospital with Naniing Medical University,Nan jing,210029,China)

机构地区南京医科大学第一附属医院心脏科

出处《临床心血管病杂志》 CAS CSCD 北大核心 2018年第7期691-695,共5页 Journal of Clinical Cardiology

基金国家科技支撑计划课题(No:2011BAI11B08) 江苏省六大人才高峰资助项目[No:WSN-031(IB15)]

关键词心力衰竭急性生长分化因子-15 预后 heart failure acute growth differentiation factor-15 prognosis

分类号 R541.6 [医药卫生—心血管疾病]

作者简介通信作者：李新立，E-mail：Xinli3267@yeah．net