心脏型脂肪酸结合蛋白在急诊胸痛患者中的诊断价值  

Diagnostic value of heart-type fatty acid-binding protein in patients with acute chest pain

作　　者：刘永娥[1] 梁华[2] 石宏宴[1] 

机构地区：[1]大连医科大学附属第二医院检验科,辽宁大连116023 [2]辽宁国际旅行卫生保健中心,辽宁大连116001

出　　处：《大连医科大学学报》2011年第4期388-390,405,共4页Journal of Dalian Medical University

摘　　要：[目的]探讨心脏型脂肪酸结合蛋白（H-FABP）在急诊胸痛患者中的诊断价值。[方法]筛选急诊胸痛患者128例（0~6 h）,立即采用H-FABP快速诊断试纸进行定性检测,同时测定血浆肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、超敏C反应蛋白（hs-CRP）水平,计算各项指标单独及联合检测在诊断急性心肌梗死（AMI）方面的灵敏度和特异度。[结果]入选患者最终确诊AMI者68例,在0-6 h内H-FABP、cTnI、CK-MB、hs-CRP检出AMI的灵敏度分别为88.23%、44.12%、41.18%、42.65%;特异度分别为83.33%、93.30%、86.67%、86.70%,在灵敏度方面H-FABP与其它指标比较差异有显著性意义（P〈0.05）;但在特异度上H-FABP与其它指标比较差异无显著性意义（P〉0.05）。各项指标联合检测的灵敏度为92.64%、特异度为91.60%,阳性预测值及阴性预测值分别为98.00%、90.00%。[结论]H-FABP是筛查急诊胸痛患者是否发生急性心肌梗死的中最灵敏的指标,具有重要的临床诊断价值;与cTnI、CK-MB、hs-CRP联合检测更能提高诊断效率。[Objective] To investigate the value of heart-type fatty acid binding protein（H-FABP） in patients with acute chest pain.[Methods] One hundred and twenty-eight patients within six hours after the onset of chest pain were selected.A qualitative detection of H-FABP was performed instantly using rapid test kit,The plasma levels of cardiac troponin I（cTnI）,creatine kinase isoenzyme-MB（CK-MB） and high sensitive C-reactive protein（hs-CRP） were detected simultaneously.The sensitivity and specificity in diagnosis of acute myocardial infarction（AMI） were calculated.[Results] Among 128 selected patients,68 had a final diagnosis of AMI.The sensitivities of H-FABP,cTnI,CK-MB and hs-CRP in diagnosis of AMI were 88.23%,44.12%,41.18% and 42.65% respectively within six hours,and the sensitivity of H-FABP was significantly higher than that of others（P〈0.05）.The specificities of H-FABP,cTnI,CK-MB and hs-CRP were 83.33%,93.30%,86.67% and 86.70% respectively.The specificity of H-FABP compared with others that was not statistically significant（P〉0.05） within 6 hours.The sensitivity（92.64%）,specificity（91.60%）,positive value（98.00%） and negative value（90.00%） of combined H-FABP,cTnI,CK-MB and hs-CRP were the highest within 0-6 hours.[Conclusion] Heart-type fatty acid binding protein is the most sensitive indicator for early AMI（within 6 hours） diagnosis and has very important application value for clinical diagnosis.The combination determination of multiple-index can improve efficiency of AMI diagnosis.

关 键 词：心脏型脂肪酸结合蛋白 急性心肌梗死 肌钙蛋白I 超敏C-反应蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]