心肌型脂肪酸结合蛋白诊断早期急性心肌梗死的价值  

Resarch on the value of the hearty fatty acid binding protein in diagonosis of early acute myocardial infarction

作　　者：曾利[1] 高全杰[1] 邓小飞[1] 尹阳光[1] 陈国柱[1] 史忠[1] 

机构地区：[1]第三军医大学新桥医院急救部,重庆400037

出　　处：《重庆医学》2010年第15期1991-1992,共2页Chongqing medicine

摘　　要：目的探讨心肌型脂肪酸结合蛋白(H-FABP)诊断早期急性心肌梗死(AMI)的价值。方法选择急性冠脉综合征(ACS)患者126例,按胸痛发作到就诊时间先后分为4h内组和4～8h组,分析胸痛发作不同时间H-FABP、肌钙蛋白I(cTnI)、磷酸肌酸同工酶(CK-MB)和肌红蛋白(MYO)在诊断AMI中的灵敏度、特异度、准确度、阳性预测值和阴性预测值。结果胸痛发作4h内,H-FABP诊断AMI灵敏度为90.1%,明显高于cTnI、CK-MB和MYO,差异有统计学意义(P<0.05);特异度为92.1%,明显高于MYO(P<0.05),与cTnI、CK-MB比较,差异无统计学意义;4～8h组H-FABP诊断AMI灵敏度为98.0%,明显高于cTnI和CK-MB(P<0.05),与MYO比较,差异无统计学意义(P<0.05);特异度为96.2%,明显高于MYO(P<0.05),与cTnI、CK-MB比较,差异无统计学意义;4个检测指标准确度、阳性预测值、阴性预测值在胸痛发作4h内和4～8h组差异均无统计学意义(P>0.05)。结论在诊断早期急性AMI,H-FABP优于传统指标cTnI、CK-MB和MYO,测定H-FABP对早期诊断AMI有重要临床意义。Objective To study the advantage of the hearty fatty acid binding protein（H-FABP） in diagonosis of early actute myocardial infarction, and to compare with cardiac troponin I（cTnI）,creatine kinase isoenzyme -MB（CK-MB） and myoglobin （MYO）. Methods One hundred and twenty-six acute coronary syndrome（ACS） patients were selected in study and divided into ,t hour group and 4 -8 hour group according to the symptom of angina appeared,and we analysed five data including the sensitivity, specificity,accuracy,positive predictive value and negative predictive of H-FABP,cTnI,CK MB and MYO. Results The sensitivity of H FABP within 4 hours was 90. 1% ,which was significantly higher than that of cTnl.CK-MB and MYO（P〈0.05） ,the specifity of H-FABP was 92.1%,which was significantly higher than that of MYO（P〈0.05）,and compared with cTnl and CK-MB it was no siginificant difference（ P〉0. 05 ）;the sensitivity of H-FABP within 4 -8 hours was 98.0% ,which was significantly higher than that of eTnI,CK-MB（P〈0.05） ,and compared with MYO it had no signifigant difference（P〉0.05） ;the specifity of H-FABP was 96.2%, which was significantly higher than MYO（P〈0.05）, and compared with cTnl and CK-MB it had no significant differ ence（P〉0.05） ;the accuracy, positive predictive value and negative predictive of H-FABP had no significant difference than those of cTnI,CK MB and MYO the two groups within 4 hours and 4-8 hours（P〉0.05）. Conclusion H-FABP is a more sensitive and specificity indicator for early AMI diagnosis than those of traditional index and has very important value in guiding cilinical energency as well.

关 键 词：心肌型脂肪酸结合蛋白 急性心肌梗死 诊断 

分 类 号：R542.22[医药卫生—心血管疾病] R446.61[医药卫生—内科学]