Clinical value of growth differentiation factor-15 on myocardial injury in pediatric critical illness / 中华实用儿科临床杂志

ABSTRACT

Objective To study the clinical value of growth differentiation factor-15 (GDF-15) in judgment of the degree of myocardial injury in children with critical illness.Methods Fifty cases of children [pediatric critical illness score (PCIS) ≤ 80] without primary cardiac disease in Pediatric Intensive Care Unit (PICU) of Changzhou Children's Hospital Affiliated to Nantong University were selected after hospitalization,and 20 healthy children were taken as normal control group (n =20).The level of GDF-15 in peripheral blood serum were detected by enzyme-linked immunosorbent assay and biochemical indicators like troponin I (cTnI),creatine kinase isoenzyme (CK-MB) and so on were recorded.Fifty cases of critically ill children were divided into myocardial injury group (n =23),and without myocardial injury group(n =27),according to the myocardial injury standard which was cTnI ＞ 0.2 μg/L.The relationship between the level of GDF-15 and myocardial injury in critically ill children was observed,and the correlation analysis of GDF-15 and cTnI was performed.Results 1.The rate of the myocardial injury in critically ill children was 46％ (23/50 cases).2.Compared with the without myocardial injury group [25.93％ (7/27 cases)] and the normal control group [5.00％ (1/20 cases)],GDF-15 positive rate in myocardial injury group [60.87％ (14/23 cases)] was significantly higher,and there were significant differences (P =0.027,0.000) ; there was no significant difference between the without myocardial injury group and the normal control group (P =0.056).3.The levels of GDF-15 had significant difference between myocardial injury group and the without myocardial injury group (P =0.000).4.GDF-15 was positively correlated with cTnI (r =0.9704,P ＜ 0.05).Conclusions The level of GDF-15 with myocardial injury in critically ill children is higher than that of without myocardial injury children.GDF-15 and cTnI have an important value in judging the degree of myocardial injury of critically ill children.