人生长分化因子-15对不同原因急性呼吸困难患者的诊断价值

发布时间：2018-02-05 01:42

本文关键词： 急性呼吸困难人生长分化因子- 诊断价值　出处：《广东医学》2017年02期 　论文类型：期刊论文

【摘要】：目的探索血浆生长分化因子(GDF)-15浓度在不同原因急性呼吸困难的变化情况、评价GDF-15水平对呼吸困难病因鉴别诊断的意义。方法选择因急性呼吸困难就诊的急诊患者120例,依据引起呼吸困难病因分为单纯肺部疾病组、肺源性心脏病组、左心功能不全组、其他原因呼吸困难组,选取同期健康体检者120例作为正常对照组。检测所有参与研究对象的GDF-15、左室舒张末径(LVEDD)、舒张末室间隔(IVS)、左室后壁(LVPW)、左房前后径(LAD)、左室射血分数(LVEF)、舒张期E峰与A峰比值(E/A值),分组比较并评价各参数对于急性呼吸困难病因鉴别诊断的价值。结果急性呼吸困难组患者与正常对照组在LVEDD、LAD、LVEF、LVPW、IVS和E/A比值等方面比较差异均有统计学意义(P0.05),在年龄及性别组成方面差异无统计学意义(P0.05);急性呼吸困难患者平均GDF-15水平显著高于正常对照组(P0.05);不同原因急性呼吸困难患者GDF-15平均水平也均显著高于正常对照组(P0.05);左心功能不全组患者GDP-15平均水平显著高于其余3组(P0.05);其他原因呼吸困难组患者GDP-15平均水平显著高于单纯肺部疾病组和肺源性心脏病组患者(P0.05);单纯肺部疾病组和肺源性心脏病组患者GDP-15平均水平比较差异无统计学意义(P0.05);左心功能不全组患者GDF-15的ROC曲线下面积最大,为0.876。结论单纯肺部疾病、肺源性心脏病以及左心功能不全等原因造成急性呼吸困难的患者在临床诊断和治疗中,GDF-15可作为鉴别呼吸困难病因的特异性指标。
[Abstract]:Objective to investigate the changes of plasma GDF-15 concentration in patients with acute dyspnea due to different causes. To evaluate the significance of GDF-15 level in differential diagnosis of dyspnea. Methods 120 emergency patients with acute dyspnea were selected and divided into simple pulmonary disease group according to the etiology of dyspnea. Pulmonary heart disease group, left ventricular insufficiency group, other causes of dyspnea group, 120 cases of health check-up were selected as the normal control group. The GDF-15 of all participants were detected. Left ventricular end-diastolic diameter (LVEDDN), ventricular septal septum (IVSV), left ventricular posterior wall (LVPWV), left atrial anterior and posterior diameter (LADV), left ventricular ejection fraction (LVVEF). The ratio of E peak to A peak in diastolic phase was compared and evaluated for the differential diagnosis of acute dyspnea. Results LVEDD was found in patients with acute dyspnea and normal controls. There were significant differences in the ratio of IVS and E / A between LVEF and LVPWV (P 0.05). There was no significant difference in age and sex composition (P 0.05). The average GDF-15 level in patients with acute dyspnea was significantly higher than that in the control group (P 0.05). The average level of GDF-15 in patients with acute dyspnea was significantly higher than that in the control group (P 0.05). The average level of GDP-15 in patients with left ventricular insufficiency was significantly higher than that in the other three groups (P 0.05). The average level of GDP-15 in patients with dyspnea for other reasons was significantly higher than that in patients with simple pulmonary disease and pulmonary heart disease (P 0.05). There was no significant difference in the average level of GDP-15 between pulmonary disease group and pulmonary heart disease group (P 0.05). The area under the ROC curve of GDF-15 was the largest in patients with left ventricular insufficiency (0.876. Conclusion simple pulmonary disease). GDF-15 in patients with acute dyspnea caused by pulmonary heart disease and left ventricular insufficiency can be used as a specific index to distinguish the etiology of dyspnea in clinical diagnosis and treatment.
【作者单位】：汕头市中心医院急诊科;
【基金】：汕头市医疗科技计划项目(编号:汕府科[2014]62号-6)
【分类号】：R459.7
【正文快照】： 呼吸困难是临床常见症状,也是急需处理的内科常见重症之一,病因诊断正确和及时,治疗得当会使病死率降低,否则,病死率明显升高[1]。生长分化因子-15(GDF-15)是转化生长因子-B(TGF-B)超家族的一员,具有不同生物学功能[2]。近年研究发现在心肌缺血和缺血再灌注损伤、心肌肥厚及心

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