心肌型脂肪酸结合蛋白检测在早期诊断STEMI中的价值  

Value of heart-type fatty acid-binding protein in early diagnosis of ST-elevation myocardial infarction

作　　者：邓小飞[1] 尹扬光[1] 史忠[1] 陈国柱[1] 程绩[1] 曾利[1] 

机构地区：[1]第三军医大学新桥医院急救部,重庆400037

出　　处：《西南国防医药》2011年第2期143-145,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨心肌型脂肪酸结合蛋白(H-FABP)检测对ST段抬高型心肌梗死(STEMI)的早期诊断价值。方法对2008年1月～2009年1月收治的78例拟诊为STEMI患者,立即进行H-FABP、心肌肌钙蛋白I(cTnⅠ)、肌酸激酶同工酶-MB(CK-MB)、肌红蛋白(MYO)检测,比较其对STEMI早期诊断的敏感性、特异性。结果拟诊78例STEMI患者中,明确诊断为STEMI的69例。在胸痛症状发生3h内,H-FABP诊断STEMI的敏感度为85.5%,明显高于MYO(73.9%)、cTnⅠ(53.6%)和CK-MB(43.5%),特异性为66.6%,高于MYO(44.4%),低于cTnⅠ(100.0%)和CK-MB(77.7%)。结论 H-FABP检测诊断早期STEMI敏感度高,特异性较高,可作为检测STEMI早期心肌损伤的可靠标志物。Objective To investigate the value of heart-type fatty acid-binding protein（H-FABP）in the early diagnosis of ST-elevation myocardial infarction（STEMI）.Methods 78 patients visiting our department from January 2008 to January 2009 were initially diagnosed as STEMI.Their plasma H-FABP,cardiac troponin Ⅰ（cTnⅠ）,creatine kinase isoenzyme-MB（CK-MB）and myoglobin（MYO）were immediately measured within 3 h after the onset.Then the diagnostic sensitivity and specificity of above indexes to STEMI was respectively compared.Results Among 78 cases of suspected STEMI,69 cases were definitely diagnosed as STEMI.The diagnostic sensitivity of H-FABP to STEMI was 85.5% within 3 h after the onset of chest pain,which was significantly higher than that of MYO（73.9%）,cTnⅠ（53.6%）and CK-MB（43.5%）.The diagnostic specificity of H-FABP to STEMI was 66.6%,which was also higher than that of MYO（44.4%）,but less than cTnⅠ（100.0%）and CK-MB（77.7%）.Conclusion H-FABP is of high sensitivity and specificity in the early diagnosis of STEMI and it can be used as a reliable marker to detect early myocardial injuries in patients with STEMI.

关 键 词：心肌型脂肪酸结合蛋白 ST段抬高型心肌梗死 心肌肌钙蛋白 肌红蛋白 肌酸激酶同工酶-MB 

分 类 号：R542.2[医药卫生—心血管疾病]