心型脂肪酸结合蛋白在急性心肌梗死早期诊断中价值  

Value of heart-type fatty acid-binding protein to the early diagnosis of acute myocardial infarction

作　　者：马春华[1] 王文红[2] 曲淑杰[3] 张彦宗[1] 秦笛[1] 

机构地区：[1]中国石油天然气集团公司中心医院急诊科,河北省廊坊市065000 [2]中国石油天然气集团公司中心医院检验科,河北省廊坊市065000 [3]中国人民解放军总参谋部中心门诊部,北京市100082

出　　处：《中华实用诊断与治疗杂志》2012年第10期976-978,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河北省廊坊市科技支撑项目(2010013029)

摘　　要：目的探讨血浆心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)对早期诊断急性心肌梗死(acute myocardial infarction,AMI)的意义。方法发病6h内以急性胸痛就诊的疑似AMI患者83例,根据出院诊断分为AMI组32例与非AMI组51例,非AMI组又分为不稳定型心绞痛33例(UAP组)与非心源性胸痛18例(NCCP组),选择体检健康者40名为对照组,采用ELISA法检测各组血清H-FABP水平,并与传统心肌标志物的诊断效能进行比较。结果 AMI组血清H-FABP水平明显高于非AMI组和对照组(P均<0.01);ROC曲线显示,H-FABP的AUC为0.954(95%CI:0.912～0.997),H-FABP诊断AMI的最佳截断值为6.65ng/mL;H-FABP诊断发病6h内AMI的敏感度、特异度、阴性预测值及准确率分别为90.26%,80.39%,93.18%,84.34%;敏感度、阴性预测值及准确率明显高于传统心肌标志物肌红蛋白、肌酸激酶同工酶和肌钙蛋白I(P<0.05)。结论 H-FABP对发病早期的AMI有较好诊断价值。Objective To investigate the value of heart-type fatty acid-binding protein （H-FABP） to the early diagnosis of acute myocardial infarction. Methods A total of 83 patients were suspected acute myocardial infarction at admission in 6 hours after onset of acute chest pain. They were randomly divided into AMI group （n=32） and non AMI group （n= 51） including 33 patients with unstable angina pectoris （UAP group） and 18 patients with non-cardiogenic chest pain （NCCP group）. Another 40 healthy volunteers were as controls （control group）. The plasma level of H-FABP was measured with ELISA, and compared with the traditional cardiac markers. Results The H-FABP level was significantly higher in AMI group than that in the other three groups （P〈0.01）. ROC curve showed AUC of H-FABP was 0. 954 （95%CI： 0. 912 to 0. 997）. The optimum cut-off point of H-FABP for diagnosing AMI was 6.65 ng/mL. The sensitivity, specificity, negative prediction value and accuracy of H-FABP for diagnosing AMI in 6 hours were 90.26%, 80.39%, 93.18% and 84. 34% respectively. The sensitivity, negative prediction value and accuracy of H-FABP were significantly higher than those of the traditional cardiac markers as myoglobin, ereatine kinase-myocardial band and cardiac troponin I （P〈0.05）. Conclusion H-FABP has better value to diagnosing AMI in the early stage.

关 键 词：急性心肌梗死 心肌型脂肪酸结合蛋白 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]