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(P<0.05),在年龄及性别组成方面差异无统计学意义(P>0.05);急性呼吸困难患者平均GDF-15水平显著高于正常对照组(P<0.05);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(P<0.05);左心功能不全组患者GDP-15平均水平显著高于其余3组(P<0.05);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(P<0.05);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(P>0.05);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.%Objective To investigate the plasma GDF-15 level in acute dyspnea changes , thus to evaluate the diagnostic value of GDF-15 on dyspnea .Methods A total of 120 emergency patients with acute dyspnea were selected and assigned into simple pulmonary disease group , pulmonary heart disease group , left ventricular dysfunction group , and other causes of dyspnea group according to causes of dyspnea .And 120 healthy physical examination participants were se-lected as normal control group .GDF-15, left ventricular end diastolic diameter (LVEDd), end diastolic interventricular septum (IVS), left ventricular posterior wall ( LVPW), left atrial diameter ( LAD), left ventricular ejection points (LVEF), and E/A value were recorded and compared .Results There were significant differences in LVEDD , LAD, LVEF, LVPW, IVS and E/A ratio between acute dyspnea patients and normal controls (P<0.05).There was no signifi-cant difference in age or sex composition between them (P>0.05).GDF-15 level was significantly higher in acute re-spiratory distress patients than control group ( P<0.05) , so were they in patients with different causes of acute dyspnea (P<0.05).The GDP-15 in left ventricular dysfunction patients was significantly higher than the other 3 groups (P<0.05).And it was significantly higher in patients with other causes of dyspnea than simple pulmonary diseases and pulmo -nary heart disease groups (P<0.05).The area under the ROC curve of GDF -15 (0.876) was the highest in left ven-tricular dysfunction patients .Conclusion GDF-15 can be used as a clinical marker for differential diagnosis of acute dyspnea
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