心肌脂肪酸结合蛋白浓度对急性冠脉综合征临床转归的预测价值  

Prognostic value of serum concentration of heart-type fatty acid-binding protein on acute coronary syndrome at early stage

作　　者：刘海波[1,2] 郭小芳 张丽梅 施育平[2] 徐耕[2] 王春明 

机构地区：[1]宁波市鄞州人民医院心内科,浙江宁波315040 [2]浙江大学医学院附属第二医院心内科,浙江杭州310009 [3]宁波市鄞州人民医院内分泌科,浙江宁波315040

出　　处：《中国病理生理杂志》2011年第2期238-242,共5页Chinese Journal of Pathophysiology

基　　金：浙江省医学会临床科研基金资助项目(No.2009ZYC31)

摘　　要：目的:探讨血浆心肌脂肪酸结合蛋白(H-FABP)浓度对急性冠脉综合征(ACS)患者临床预后的预测价值。方法:连续入选172例住院的ACS患者,于出现胸痛6 h内测定H-FABP浓度,并随访1年,以再发心血管事件(包括心脏性死亡、非致命性心肌梗死、非致命性心力衰竭及反复心绞痛发作住院)作为研究终点。结果:经过1年随访,共有47例患者发生心血管事件,其中心脏性死亡6例,非致命性心肌梗死9例,非致命性心力衰竭11例,反复心绞痛发作住院21例。心血管事件组H-FABP浓度较无心血管事件组显著增高(P<0.01);H-FABP浓度增高(>中位数12.5μg/L)组患者出现心血管事件明显增加(36例vs 11例,P<0.01);Cox比例风险模型多因素逐步分析显示H-FABP浓度增高是ACS患者再发心血管事件的独立危险因子(RR=5.430,P<0.01;95%CI 2.587-11.398)。结论:H-FABP浓度增高的ACS患者再发心血管事件风险显著增加,H-FABP浓度增高可能是ACS患者预后的独立预测因子。AIM ： To investigate the prognostic value of serum concentration of heart - type fatty acid - binding protein（ H -FABP） at early stage of acute coronary syndrome（ACS）. METHODS： This was a prospective observational study with a follow - up of 12 months. The H - FABP was measured within 6 h after onset of chest pain in 172 consecutive patients hospitalized for ACS. The.study endpoints were cardiac events, which were defined as cardiac death, subsequent nonfatal acute myocardial infarction（ AMI）, nonfatal heart failure and recurrent angina. RESULTS： During the period of 12 -month follow -up, 47 cardiac events, including 6 cardiac deaths, 9 nonfatal AMIs, 11 nonfatal heart failures and 21 recurrent anginas, were observed. The concentrations of H - FABP in the patients with cardiac events were significantly higher than those in the patients without cardiac events（ P 〈0. 01 ）. Meanwhile, the cardiac events were more prevalent in increased H- FABP（above the median of 12. 5 μg/L） group（36 events vs 11 events, P 〈0. 01 ）. In a Cox proportional hazards model that adjusted for baseline variables including demographics, clinical characteristics, ST deviation and tropo- nin I, increased H -FABP（ above the median of 12. 5 μg/L） was independently associated with cardiac events in all patients [ relative risk（RR） = 5. 430, P 〈 0. 01 ;95% CI 2. 587 - 11. 398 ]. CONCLUSION： Elevation of H - FABP is associated with an increased risk of cardiac events in patients presenting across the spectrum of ACS and is independent of other established clinical risk predictors and biomarkers.

关 键 词：心肌脂肪酸结合蛋白 急性冠脉综合征 预测 

分 类 号：I543.32[文学—其他各国文学]