心型脂肪酸结合蛋白对非ST段抬高急性冠脉综合征早期诊断及预后的探讨  

Early diagnosis and prognostic value of a qualitative test for heart-type fatty acid-binding protein in patients with acute coronary syndrome(ACS)

作　　者：林岫芳[1] 董丹丹[1] 夏小明[1] 

机构地区：[1]中山大学附属第五医院心内科,广东珠海519000

出　　处：《中国医师杂志》2006年第11期1443-1445,共3页Journal of Chinese Physician

基　　金：广东省珠海市科技局资助项目(PC20041036)

摘　　要：目的探讨心型脂肪酸结合蛋白（H—FABP）对非ST段抬高急性冠脉综合征（ACS）早期诊断及预后判定的价值。方法测定268例胸痛患者血清H-FABP和肌钙蛋白T（cTnT），对临床最终确诊的112例ACS患者H—FABP水平进行分析，并观察入院30d内预后不良组（高危险组）患者H—FABP的变化。结果胸痛出现3h内，H—FABP和TnT检测ACS阳性率分别为49．1％和9．1％，二者差异有统计学意义（P〈0．001）。高危险组H—FABP阳性率94.7％，阴性率5.2％（P〈0.001）。ACS患者危险分层越高，血清中H—FABP浓度越高。在校对了肌钙蛋白T、左心室射血分数等影响因素后，H-FABP仍是影响ACS患者预后的独立危险因素[95％可信区间，2．258（1.268～3.896）]。结论H—FABP对ACS早期诊断及预后判定具有重要临床价值。Objective To determine the early diagnosis and prognostic value of a qualitative test for Heart-Type Fatty Acid-Binding Protein（H-FABP） in patients with ACS. Methods A observational study was conducted on patients at our hospital. 268 patients who presented with chest pain were tested for serum H-FABP and troponin T （cTnT）. Among which, 112 patients were admitted for ACS and their H-FABP levels were analyzed. Follow-up information on adverse events within 30 clays after admission, defined as high risk stratification, was obtained from the medical records. Results The tests for H-FABP and troponin T were positive in 49. 1% and 9. 1% （ P 〈0. 001 ） of the patients respectively within 3 hours accompanying chest pain attack for ACS. The H-FABP-positive rate was 94. 7% and the negative rate was 5.2% in the group of high risk stratification at 30 clays （ P 〈0. 001 ）. The adjusted relative risk of a positive H-FABP test for adverse events was 2. 258 （95% Cl： 1. 268 to 3. 896）. The higher the H-FABP levels ,the higher the risk stratification was. Conclusion A positive H-FABP test was valuahle in early diagnosis of ACS , especially within 3 hours after chest pain attack and can be an independent predictor of poor prognosis within 30 clays period in ACS patients.

关 键 词：载体蛋白质类/诊断应用 脂肪酸类/诊断应用 冠状动脉疾病/诊断 

分 类 号：R541.4[医药卫生—心血管疾病]