天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (1): 42-46.doi: 10.11958/20181360

• 临床研究 • 上一篇    下一篇

慢性心衰患者血清GDF-15与PⅠCP、 PⅢNP的相关性分析

曾超 1，2，于盼盼 1，2，李彩虹 2，3，陈万里 2，3，朱振宇 2，3，齐新 2△   

  1. 基金项目：天津市科委慢性疾病防治科技重大专项（16ZXMJSY00060）；天津市卫生计生委科技基金资助项目（2015KG110） 作者单位：1天津医科大学研究生院（邮编300070）；2天津市人民医院心脏内科；3天津中医药大学 作者简介：曾超（1992），男，硕士在读，主要从事心血管疾病的发病机制方面研究 △通讯作者 E-mail: qixinx2011@126.com
  • 收稿日期:2018-09-10 修回日期:2018-11-19 出版日期:2019-01-15 发布日期:2019-01-15
  • 通讯作者: 齐新 E-mail:qixinx2011@126.com
  • 基金资助:
    高血压病人心肾早期损害的危险分层及治疗策略的研究

Correlation between serum GDF-15, serum PⅠCP and PⅢNP in patients with chronic heart failure

ZENG Chao1,2, YU Pan-pan1,2, LI Cai-hong2,3, CHEN Wan-li2,3, ZHU Zhen-yu2, 3, QI Xin2△   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of Cardiology, Tianjin Union Medical Center; 3 Tianjin University of Traditional Chinese Medicine △Corresponding Author E-mail: qixinx2011@126.com
  • Received:2018-09-10 Revised:2018-11-19 Published:2019-01-15 Online:2019-01-15
  • Contact: QI Xin E-mail:qixinx2011@126.com

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摘要： 目的 检测心力衰竭（心衰）患者血清生长分化因子15（GDF-15）与Ⅰ型前胶原羧基端肽（PⅠCP）、Ⅲ型前 胶原氨基端肽（PⅢNP）的变化并分析其相关性，探究GDF-15对心衰患者心室重构的指导作用。方法 纳入219例 心衰患者，按照美国纽约心脏病协会（NYHA）心功能分级分为NYHAⅠ级组58例、Ⅱ级组39例、Ⅲ级组47例、Ⅳ级组 75例；按左室射血分数（LVEF）分为射血分数减低的心衰组（LVEF＜0.45，HFrEF组，69例）和射血分数保留的心衰组 （LVEF≥0.45，HFpEF组，150例）；选取32例同期健康体检者作为对照组。采用ELISA法检测血清GDF-15、PⅠCP、P ⅢNP 水平，超声心动图测量左室舒张末期内径（LVEDD）、左心房内径（LA）、室间隔厚度（IVST）、左室后壁厚度 （LVPWT）以及 LVEF，计算左室质量指数（LVMI），并分析心衰患者血清 GDF-15 与 PⅠCP、PⅢNP、NT-proBNP、 LVEDD、LA、LVMI及LVEF的相关性。结果 心衰患者血清NT-proBNP、GDF-15、PⅠCP、PⅢNP水平随NYHA分级 增加而升高（P＜0.05）。对照组、HFpEF组和HFrEF组LA、LVEDD、LVMI、NT-proBNP、GDF-15、PⅠCP及PⅢNP依 次升高（P＜0.05）。心衰患者血清GDF-15水平与PⅠCP、PⅢNP、NT-proBNP、LA、LVEDD、LVMI呈正相关（rs分别为 0.549、0.533、0.539、0.393、0.403、0.485，均 P＜0.01），与 LVEF 呈负相关（rs=-0.568，P＜0.01）。结论 心衰患者血清 GDF-15与心衰严重程度相关，并可反映心衰患者心室重构情况。

关键词: 心力衰竭, 心室重构, 生长分化因子15, Ⅰ型前胶原羧基端肽, Ⅲ型前胶原氨基端肽

Abstract: Objective To detect the changes of serum growth differentiation factor 15 (GDF-15) and type Ⅰ procollagen carboxy terminal peptide (PⅠCP) and type Ⅲ procollagen amino terminal peptide (PⅢNP) in patients with heart failure, and to analyze the correlation between GDF-15, PⅠCP and PⅢNP, and to explore the guiding role of GDF-15 in ventricular remodeling in patients with heart failure. Methods A total of 219 patients with heart failure were enrolled. Patients were divided into heart function Ⅰ grade (n= 58), Ⅱ grade (n=39), Ⅲ grade (n=47), and Ⅳ grade (n=75) groups in accordance with New York Heart Association (NYHA). According to left ventricular ejection fraction (LVEF), the heart failure patients were divided into heart failure with reduced LVEF group (LVEF＜ 0.45, n=69) and heart failure with preserved LVEF group (LVEF≥0.45, n=150). And 32 healthy subjects were chosen as the control group. Serum levels of GDF-15, PⅠCP, and PⅢNP were measured by ELISA. Left ventricular end-diastolic diameter (LVEDD), left atrial (LA), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular ejection fraction (LVEF) were measured by echocardiography. The left ventricular mass index (LVMI) was calculated. And also the correlation between serum GDF-15 and PⅠCP, PⅢNP, NT-proBNP, LVEDD, LA, LVMI and LVEF were analyzed in patients with heart failure. Results Serum levels of GDF-15, PⅠCP, PⅢNP and NT-proBNP were significantly elevated in patients with heart failure (P＜ 0.05), and increased with the increasing NYHA classification. The serum levels of LA, LVEDD, LVMI, NT-proBNP, GDF-15, PⅠCP and PⅢNP were increased in turn in control group, HFpEF group and HFrEF group (P＜0.05). Serum GDF-15 levels were positively correlated with PⅠCP, PⅢNP, NT-proBNP, LA, LVEDD, and LVMI in patients with heart failure (rs=0.549, 0.533, 0.539, 0.393, 0.403, 0.485, P＜0.01), and negatively correlated with LVEF (rs=-0.568, P＜0.01). Conclusion Serum GDF-15 is associated with the severity of heart failure and may reflect ventricular remodeling in patients with heart failure.

Key words: heart failure, ventricular remodeling, growth differentiation factor 15, C-terminal propeptide of collagen type Ⅰ, Nterminal propeptide of collagen type Ⅲ