生长分化因子-15 和β2-微球蛋白对先天性心脏病合并慢性心力衰竭患儿的诊断价值及其与心功能的关系。
Diagnostic value of growth differentiation factor-15 and β2-microglobulin in children with congenital heart disease combined with chronic heart failure and its relationship with cardiac function.
机构信息
Department of Clinical Laboratory, The Second Hospital of Shandong University, Jinan, Shandong, China.
出版信息
Eur Rev Med Pharmacol Sci. 2020 Aug;24(15):8096-8103. doi: 10.26355/eurrev_202008_22494.
OBJECTIVE
This study aimed to investigate the diagnostic value of growth differentiation factor-15 (GDF-15) and β2-microglobulin (β2-MG) in infants with congenital heart disease (CHD) combined with chronic heart failure and its relationship with cardiac function.
PATIENTS AND METHODS
A total of 100 cases of infants diagnosed with CHD combined with chronic heart failure in our hospital from July 2015 to July 2018 were selected as the experimental group, and 80 cases of healthy subjects underwent health examination in our hospital during the same period were selected as the control group. The levels of serum GDF-15 and β2-MG and LVEF index of the two groups were compared. The correlation analysis of GDF-15 and β2-MG levels and cardiac function classification was conducted. The diagnostic value of GDF-15 and β2-MG was analyzed by ROC curve.
RESULTS
The levels of GDF-15 and β2-MG were significantly higher in severe and moderate heart failure groups than those in mild heart failure group, and the levels were significantly higher in severe heart failure group than those in moderate heart failure group (p<0.001). Levels of GDF-15 and β2-MG in the experimental group were significantly higher than those in the control group (p<0.001) and the LVEF index in the experimental group was significantly lower than that in the control group (p<0.001). There was a positive correlation between levels of GDF-15 and β2-MG and the severity of heart failure. The sensitivity, specificity, and AUC of GDF-15 alone in diagnosis of CHD combined with chronic heart failure were respectively 91.25%, 74.00% and 0.821, those of β2-MG alone were 82.50%, 62.00% and 0.819, and those of GDF-15 combined with β2-MG were 82.50%, 82.00% and 0.888. In the prognosis, the sensitivity of GDF-15 and β2-MG was respectively 91.30%, 56.52%, specificity was 62.96%, 94.44%, and AUC was 0.806, 0.817.
CONCLUSIONS
Levels of GDF-15 and β2-MG are positively correlated with the severity of cardiac function, which can be used as an ideal indicator for early diagnosis of CHD combined with chronic heart failure, as well as a clinical indicator to judge the condition.
目的
本研究旨在探讨生长分化因子 15（GDF-15）和β2-微球蛋白（β2-MG）在先天性心脏病（CHD）合并慢性心力衰竭患儿中的诊断价值及其与心功能的关系。
方法
选取 2015 年 7 月至 2018 年 7 月我院收治的 100 例 CHD 合并慢性心力衰竭患儿为实验组，同期在我院体检的 80 例健康者为对照组。比较两组血清 GDF-15、β2-MG 水平及左心室射血分数（LVEF）指数，对 GDF-15、β2-MG 水平与心功能分级的相关性进行分析，采用 ROC 曲线分析 GDF-15、β2-MG 的诊断价值。
结果
重度和中度心力衰竭组 GDF-15、β2-MG 水平均显著高于轻度心力衰竭组，重度心力衰竭组显著高于中度心力衰竭组（p<0.001）。实验组 GDF-15、β2-MG 水平均显著高于对照组（p<0.001），实验组 LVEF 指数显著低于对照组（p<0.001）。GDF-15、β2-MG 水平与心力衰竭严重程度呈正相关。GDF-15 单独诊断 CHD 合并慢性心力衰竭的灵敏度、特异度和 AUC 分别为 91.25%、74.00%和 0.821，β2-MG 单独诊断的灵敏度、特异度和 AUC 分别为 82.50%、62.00%和 0.819，GDF-15 联合β2-MG 诊断的灵敏度、特异度和 AUC 分别为 82.50%、82.00%和 0.888。在预后方面，GDF-15 和β2-MG 的灵敏度分别为 91.30%、56.52%，特异度分别为 62.96%、94.44%，AUC 分别为 0.806、0.817。
结论
GDF-15、β2-MG 水平与心功能严重程度呈正相关，可作为 CHD 合并慢性心力衰竭早期诊断的理想指标，也是判断病情的临床指标。
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