摘要
目的探讨心型脂肪酸结合蛋白在急性心肌梗死早期诊断中的应用价值。方法选择在胸痛发作3h以内就诊的患者150例,分别于胸痛发作0~3h、3~6h和6~12h检测血清心型脂肪酸结合蛋白(hearty fatty acid binding protein,H-FABP)、心肌肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnI)、肌酸激酶同工酶(creatine kinase isoenzyme MB,CK-MB)和肌红蛋白(myoglobin,MYO)的水平变化,并比较4种心肌标志物诊断早期AMI的敏感性、特异性、阳性预测值和阴性预测值,同时比较胸痛患者发作≤8h时不同心肌标志物联合诊断AMI的敏感性和特异性。结果 AMI患者在胸痛发作3个时间段内血清H-FABP水平均明显高于非AMI组和对照组(P<0.05),非AMI组与对照组差异无统计学意义(P>0.05)。胸痛患者发作0~3 h内H-FABP的敏感性、阳性预测值、阴性预测值均比cTnI、CKMB和MYO高(P<0.05);3~6 h内H-FABP的敏感性、特异性在4者当中最高(P<0.05)。胸痛发作≤8 h,HFABP+cTnI+MYO联合检测对AMI早期诊断的敏感性最高(94.1%)。结论 H-FABP对于诊断早期AMI具有较高敏感性和良好的特异性,在早期AMI诊断方面是一项具有巨大潜力的生化心肌标志物。胸痛发作≤8 h时,HFABP+cTnI+MYO联合检测可进一步提高AMI早期诊断的敏感性,优于传统的cTnI+CK-MB+MYO联合检测。
Objective To invastigate the value of hearty fatty acid binding protein（ H-FABP） in early diagnosis of acute myocardial infarction（ AMI）. Methods 150 patients with chest pain were enrolled in this study. According to the onset times of chest pain： 0-3 h,3-6 h and 6-12 h,the levels of serum H-FABP,cTnI,CK-MB and MYO were detected. The sensitivity,specificity,positive predictive value and nagative predictive value were compared about the diagnosis of early AMI. The diagnostic sensitivity and specificity of different myocardial markers in AMI were compared within 8 h. Results The levels of H-FABP in AMI patients with chest pain of three noset time periods were significantly higher than the non-AMI group and the control group（ P〈 0. 05）. There was no significant different of the non-AMI group comparing with the control group（ P 〉0. 05）. While the onset time of chest pain within 3 h,the sensitivity,positive predictive value and nagative predictive value were higher than cTnI,CK-MB and MYO（ P〈 0. 05）. The sensitivity and specificity of H-FABP within 3-6 h were highest among the four markers. Combination detecton of H-FABP,cTnI and MYO,the sensitivity（ 94. 1%） was highest in the early diagnosis of AMI with chest pain onset within 8 h（ P〈 0. 05）. Conclusion H-FABP is more sensitive and specific in diagnosis of early AMI,which may have great potential as an excellent biochemical myocardial marker for diagnosis of AMI in the early phase. Combination detecton of H-FABP,and cTnI and MYO can increase the sensitivity in patients with chest pain onset within 8 h,and it is superior to the combination detecton of cTnI,CK-MB and MYO.
出处
《现代医院》
2017年第10期1545-1548,共4页
Modern Hospitals
关键词
急性心肌梗死
心型脂肪酸结合蛋白
心肌标志物
早期诊断
Acute Myocardial In fa rc t io n
Hearty Fatty A c id B inding P ro te in
Myocardial M a rk e r
Early Diagnostic
