2024 年第 8 期 第 0 卷

生长分化因子15和碱性磷酸酶水平对冠心病患者冠状动脉病变程度的预测价值

The predictive value of growth differentiation factor-15 and alkaline phosphatase levels on the degree of coronary artery disease in patients with coronary atherosclerotic heart disease

作者：郭欣君杜佩蓉宋哲宿昕乌力亚苏

英文作者：Guo Xinjun Du Peirong Song Zhe Su Xin Wuliyasu

单位：内蒙古自治区人民医院心血管内科，呼和浩特010017

英文单位：Department of Cardiovascular Medicine Inner Mongolia People′s Hospital Hohhot 010017 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；生长分化因子15；碱性磷酸酶；冠状动脉病变程度；糖尿病

英文关键词：Coronaryatheroscleroticheartdisease;Growthdifferentiationfactor-15;Alkalinephosphatase;Degreeofcoronaryarterydisease;Diabetesmellitus

• 摘要：

• 目的 探讨生长分化因子15（GDF-15）和碱性磷酸酶(ALP)对冠心病（冠状动脉粥样硬化性心脏病）患者冠状动脉病变程度的预测价值。方法 选取2021年1月至2023年12月在内蒙古自治区人民医院心血管内科住院的患者140例。根据最终诊断分为冠心病合并糖尿病组（46例）、冠心病组（51例）和对照组（冠状动脉造影检查未见明显狭窄病变的非冠心病患者，43例）。比较3组GDF-15、ALP水平及Gensini评分，3组不同民族构成比和不同民族患者间以上指标的差异。分析GDF-15、ALP水平与冠心病发生风险的关系及二者对冠状动脉病变程度的预测价值。结果 冠心病组、冠心病合并糖尿病组GDF-15、ALP水平及Gensini评分均高于对照组，冠心病合并糖尿病组高于冠心病组（均P＜0.05）。3组患者不同民族构成比差异无统计学意义（P>0.05）。汉族与蒙古族患者GDF-15、ALP水平和Gensini评分差异均无统计学意义（均P>0.05）。Logistic回归分析结果显示，冠心病发生风险随GDF-15（比值比=2.356，95%置信区间：1.608～3.451，P<0.001）和ALP（比值比=1.117，95%置信区间：1.019～1.225，P=0.019）水平的升高而增加。受试者工作特征曲线分析结果显示，GDF-15、ALP及二者联合预测冠状动脉病变程度的曲线下面积（AUC）分别为0.929、0.796和0.939，二者联合预测的AUC大于单个指标（均P<0.05）。结论 冠心病患者GDF-15、ALP表达水平升高，且与糖尿病、冠状动脉病变程度相关，二者联合检测对冠状动脉病变严重程度具有良好预测价值。

• Objective To explore the predictive value of growth differentiation factor-15 (GDF-15) and alkaline phosphatase (ALP) levels on the degree of coronary artery disease in patients with coronary atherosclerotic heart disease (CHD). Methods  A total of 140 patients hospitalized in the Department of Cardiovascular Medicine, Inner Mongolia People′s Hospital from January 2021 to December 2023 were selected. According to the final diagnosis, they were divided into CHD with diabetes mellitus group (46 cases), CHD group(51 cases) and control group (43 cases of non CHD patients without obvious stenosis in coronary angiography). The levels of GDF-15, ALP, and Gensini score were compared, and the differences in the composition ratio of different ethnic among three groups of patients and the above indicators among different ethnic patients were compared. The relationship between GDF-15 and ALP levels and the risk of CHD, as well as their predictive value for the degree of coronary artery disease were analyzed. Results  The GDF-15, ALP levels and Gensini score in CHD group and CHD with diabetes mellitus group were higher than those in control group, while those in CHD with diabetes mellitus group were higher than those in CHD group(all P<0.05). There was no statistically significant difference in the proportion of different ethnicities among the three groups(P>0.05). There was no statistically significant difference in GDF-15, ALP levels and Gensini score between Han and Mongolian patients (all P>0.05). The results of Logistic regression analysis showed that the risk of CHD increased with an increase of the levels of GDF-15 (odds ratio=2.356, 95% confidence interval: 1.608-3.451, P<0.001) and ALP(odds ratio=1.117, 95% confidence interval: 1.019-1.225, P=0.019). The analysis of the receiver operating characteristic showed that, the area under the curve (AUC) for predicting the degree of coronary artery disease using GDF-15, ALP, and their combination were 0.929, 0.796, and 0.939, respectively. The AUC predicted by the combination of GDF-15 and ALP was greater than that of a single indicator (both P<0.05). Conclusions  The expression levels of ALP and GDF-15 in patients with CHD increased and are related to diabetes mellitus and the degree of coronary artery disease. The combined detection of the two indexes has a good predictive value for the degree of coronary artery disease.