摘要
目的用胶乳增强免疫比浊法测定心型脂肪酸结合蛋白(H-FABP),评价其作为心肌标志物在急性心肌梗死(AMI)早期的诊断价值。方法根据临床特点、心电图表现及冠脉造影结果,将高度疑诊为AMI的患者79例分为AMI组48例和非AMI组31例,动态测定各患者H-FABP、肌钙蛋白I(CTn-I)、肌红蛋白(Mb)血清水平;同时选择健康者103例,作为正常组。建立胶乳增强免疫比浊法正常人H-FABP基线分泌及比较不同年龄、性别分布,比较3种标志物在各时间点预测AMI的敏感度、特异度、阳性预告值、阴性预告值等。结果正常人参考范围为2.21μg/L^8.47μg/L,不同年龄、性别比较,除9岁~28岁组与29岁~51岁组比较,差异无统计学意义(P>0.05)外,其他各组间比较,差异均具有统计学意义(P<0.05);H-FABP释放动力学与Mb相似,与CTn-I比较,H-FABP早期预测AMI的灵敏度高,特异度差,阳性预告值及阴性预告值相比在多个时间点差异有统计学意义(P<0.05或P<0.01)。结论 HFABP虽然特异度较差,但早期预测AMI的敏感度高,AMI患者早期进行H-FABP的测定有重要的临床价值。
Objective To evaluate the early diagnostic value of latex- enhanced immunoturbidimetry in the detection of serum heart type fatty acid binding protein（ H- FABP） as myocardial markers in acute myocardial infarction（ AMI）. Methods According to the clinical characteristics,electrocardiogram and coronary angiography results,79 cases of highly suspected diagnosis AMI patients were divided into AMI group（ 48 cases） and non- AMI group（ 31 cases）. The patient＇s serum levels of H-FABP,troponin I（ CTn- I） and myoglobin（ Mb） were dynamically determined. At the same time 103 cases of healthy people were chosen as normal group. H- FABP baseline secretion of normal people was established with latex- enhanced immuneturbidimetry and the different age and sex distribution were compared. In addition the specificity,sensitivity,positive forecast value and the negative forecast value of three markers were compared at various time points to predict AMI. Results The H- FABP＇s normal reference range from 2. 21 μg / L to 8. 47 μg / L,and the difference between the group of 9 ～ 28 years old and the group of 29 ～ 51 years old had no statistical significance,except this comparison,in other comparisons of groups,the differences are statistically significant（ P〈0. 05）; H- FABP release kinetics is similar to Mb; Compared with CTn- I,H- FABP early prediction AMI have high sensitivity but less specificity,at the same time,the difference of their positive forecast value and the negative forecast value at multiple time points were statistically significant（ P〈0. 05 or P〈0. 01）. Conclusion Although the specificity of H- FABP to early prediction AMI is relatively poor,the sensitivity is high,so the AMI patients to determine the H- FABP have important clinical value.
出处
《中国卫生检验杂志》
CAS
2015年第1期76-79,共4页
Chinese Journal of Health Laboratory Technology
关键词
胶乳增强免疫比浊法
心型脂肪酸结合蛋白
急性心肌梗死
Latex-enhanced immunoturbidimetry
Heart type fatty acid binding protein（H-FABP）
Acute myocardial infarction（AMI）
