急性心肌梗死再灌注心肌脂肪酸结合蛋白临床研究  

Clinical study of heart-typed fatty acid bingding protein after reperfusion for the acute coronary syndrome

作　　者：李明[1] 张言镇[2] 周衍菊[2] 李玉[1] 邱炳华[1] 

机构地区：[1]潍坊医学院内科教研室,261042 [2]山东省潍坊市人民医院

出　　处：《中国医学创新》2011年第7期16-19,共4页Medical Innovation of China

摘　　要：目的评价急性心肌梗死再灌注后心肌脂肪酸结合蛋白水平及其对再通的诊断价值。方法收集2009年1月～2010年1月急诊连续收入的急性冠脉综合征的患者146例,分为四组:急性心肌梗死未干预组56例,急性心肌梗死溶栓后未开通组22例,急性心肌梗死经皮冠状动脉介入组30例,急诊溶栓开通组38例。测量入院或干预后90 min内的血清脂肪酸结合蛋白,通过酶联免疫吸附实验测其浓度。结果四个研究组中急性心肌梗死与溶栓后未开通组及经皮冠状动脉介入组与急诊溶栓开通组的脂肪酸结合蛋白浓度差异无统计学意义,而其余各组两两之间差异有统计学意义。ROC曲线下面积为0.889,诊断准确率为84.44%。结论随着心肌梗死后冠状动脉的再通,心肌存在缺血再灌注损伤,血清中脂肪酸结合蛋白明显增高;以脂肪酸结合蛋白为溶栓后冠状动脉再通的指标准确性较好,有望成为判断再通的临床指标。Objective To evaluate the level of the heart - typed fatty acid binding protein （ H - FABP） of the acute coronary syndrome patients and the diagnostic value of the reperfusion of the coronary artery or not. Methods 196 patients were included in this study and devided into five groups： Stable Angina group 50 cases, acute myocardial infarction group 56 cases, no -reperfusion group after thrombolytie therapy （TT） 22 cases, pereutaneous coronary intervention （PCI） group 30 cases and reperfusion group after Tr 38 cases. Serum sapmle was obtained from the patients who were performed by PCI or thrombolytic therapy. The serum concentrations of the FABP was measured by enzyme - linked immunosorbent assay （ ELE- SA）. Results There was no difference between acute myocardial infarction group and no - reperfusion group as well as between PCI group and reperfusion group. There was significance in the every rest groups. ROC curve area of the H - FABP was 0. 889, and the diagnotic accuracy was 84.44%. Conclusion The H - FABP was a higher level because of the ischemia reperfusion injury and could be a better predictor as reperfusion or not.

关 键 词：急性心肌梗死 再灌注 心肌脂肪酸结合蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]