心肌型脂肪酸结合蛋白(H-FABP)、cTnI与CK-MB在诊断早期AMI中的比较  

Comparison of Heart-type Fatty Acid Binding Protein (H-FABP), cTnI and CK-MB in Diagnosis of Early AMI

作　　者：刘琼[1] 赵水平[1] 洪绍彩[1] 

机构地区：[1]中南大学湘雅二医院心内科,湖南长沙410011

出　　处：《实用预防医学》2006年第3期555-557,共3页Practical Preventive Medicine

摘　　要：目的 研究血清心肌型脂肪酸结合蛋白（H—FABP）在早期急性心肌梗死（AMI）诊断中的价值。方法 选择82例疑似急性心肌梗死的胸痛患者，采用快速检测法检测患者发病0～3h、3～6h和6h后血清的H—FABP，并与心肌肌钙蛋白Ⅰ（cTnⅠ）、肌酸激酶同工酶（CK—MB）的检测结果进行比较，分析3种心肌标志物在诊断不同发病时间段AMI的敏感性和特异性。结果 H—FABP检测诊断AMI的敏感性在0～3h（66．7％）和3～6h（100％）时间段显著高于cTnⅠ（33．3％、66．7％）和CK—MB（0％、61％）；在诊断特异性上，H—FABP高于cTnⅠ，比CK—MB低；H—FABP诊断AMI的准确率高达94．15％。结论 H—FABP对于诊断早期AMI具有较高的敏感性和良好的特异性，更适合于临床AMI的早期诊断。Objective To compare the diagnostic efficacy of a newly developed whole blood rapid panel test for heart - type fatty acid binding protein （H - FABP） with that of cardiac troponin Ⅰ （cTnⅠ） and creatine kinase isoenzyme MB （CK - MB）. Methods Eighty-two patients with suspected acute myocardial infarction （AMI） according to certain time frames from onset to presentation. The rapid panel test method was applied to detect the H - FABP and cTnl. The serum OK - MB activity was determined with an immuno- inhibition assay kit. The sensitivity and specificity in diagnosis of early AMI were analyzed between H - FABP and cTnⅠ and OK - MB. Results Final diagnosis was confirmed within 42 patients who were suspected AMI. The overall sensitivities of H - FABP, cTnⅠ and OK - MB were 8.5.7%, 76.2% and 31.7%, respectively. The relative sensitivities of these 3 markers were 66.7%, 100% and 0% for AMI patients presented within 3h of onset of symptom; 100%, 67% and 67% for those between 3 and 6h. While the relative specificities of these 3 markers were 100%, 50% and 100% within 3h of onset, and 94%, 7.5% and 100% for those between 3h and 6h. Negative predictive values were 100%, 67% and 84% for patients within 6h of onset. Conclusions H- FABP is more sensitive and specific in diagnosis of early AMI, which may has great potential as an excellent biochemical cardiac marker for diagnosis of AMI in the early phase.

关 键 词：急性心肌梗死 心肌型脂肪酸结合蛋白(H—FABP) 心肌肌钙蛋白Ⅰ 肌酸激酶同工酶 

分 类 号：R541[医药卫生—心血管疾病]