脂肪酸结合蛋白对急性心肌梗死的诊断及近期预后价值研究  

Values of Fatty Acid-Binding Protein in the Diagnosis and Short-Term Prognosis of Patients with Acute Myocardial Infarctions

作　　者：李响[1] 王春梅[1] 朱小玲[1] 艾辉[1] 张倩[1] 刘子军[1] 

机构地区：[1]首都医科大学附属北京安贞医院抢救中心,北京市100029

出　　处：《中国全科医学》2011年第32期3681-3683,共3页Chinese General Practice

摘　　要：目的探讨脂肪酸结合蛋白(FABP)对急性心肌梗死(AMI)的诊断及近期预后价值。方法选择2009年6月—2010年6月发病时间≤4 h的AMI患者254例,根据入院时FABP检测结果分为阳性组(FABP阳性)与对照组(FABP阴性),观察两组患者的临床特征及预后。结果 254例患者中入院时FABP阳性组179例,对照组75例。入院时2组年龄、男性比例、吸烟史、糖尿病史、高血压史、吸烟史、心电图表现、接受冠状动脉造影比例、双支血管病变例数及治疗方式等,差异均无统计学意义(P>0.05)。但阳性组多支血管病变例数和住院期间病死率明显高于对照组,而单支血管病变比例和左室射血分数明显低于对照组,差异有统计学意义(P<0.05)。对影响住院期间病死率的Logistic分析结果显示入院时FABP阳性是影响住院期间病死率的独立危险因素〔OR=1.329,95%CI(0.962,2.148),P=0.022〕。结论 FABP对AMI不仅具有早期诊断价值,还是判断近期预后的重要指标。Objective To investigate the values of fatty acid-binding protein（FABP） in the diagnosis and short-term prognosis of patients with acute myocardial infarctions.Methods A total of 254 unselected consecutive patients（symptom-to-admission time≤4 h）with AMI treated at the emergency department of Beijing Anzhen Hospital from June.2009 to June.2010 were enrolled in this study.The patients were divided into the FABP positive group and the control group（the FABP negative group）according to FABP serum levels measured from the initial blood samples.Clinical features and prognosis were observed in the two groups.Results Of the 254 patients enrolled,179 were FABP positive cases and 75 were FABP negative.Baseline data（age,gender,hypertension history,diabetes history,smoking history,initial electrocardiographic findings,rates of coronary angiography,double-vessel disease and treatment） were not significantly different between the 2 groups（P0.05）.FABP positive patients had significantly higher risk of multi-vessel disease and in-hospital mortality but lower LVEF and lower ratio of single-vessel disease（P0.05）.Logistic analysis revealed that FABP was an independent predictor for in-hospital death（OR=1.329,95%CI（0.962,2.148）,P=0.022）.Conclusion FABP is identified not only as an early diagnosis indicator of AMI,but also an indicator for predicting the prognosis.

关 键 词：脂肪酸结合蛋白 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]