心型脂肪酸结合蛋白与高敏肌钙蛋白T联合检测在急性心肌梗死早期诊断中的价值  

Value of the hearty fatty acid binding protein with high sensitive Troponin T combination detection in early diagnosis of acute myocardial infarction

作　　者：乔维洲[1] 徐维家[1] 宋晶[1] 

机构地区：[1]大连市中心医院检验科,辽宁大连116033

出　　处：《国际检验医学杂志》2012年第23期2859-2860,2862,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨心型脂肪酸结合蛋白(H-FABP)与高敏肌钙蛋白T(hs-cTnT)联合检测在急性心肌梗死(AMI)早期诊断中的应用价值。方法选择380例急诊胸痛患者,按胸痛发作到就诊时间分为小于3h、3～6h和>6h3组,检测各组H-FABP、hs-cTnT、肌酸激酶同工酶(CK-MB)水平,比较3种心肌标志物诊断AMI的敏感度、特异度、阳性预测值和阴性预测值,同时比较胸痛发作小于或等于6h不同心肌标志物联合检测诊断AMI的敏感度、特异度、阳性预测值和阴性预测值。结果胸痛发作小于3h组H-FABP诊断AMI敏感度与其他指标比较差异有统计学意义(P<0.05);>6h组hs-cTnT敏感度和特异度均优于H-FABP,差异有统计学意义(P<0.05);<3h组H-FABP与hs-cTnT联合检测诊断AMI的敏感度为91.5%,特异度为83.3%,hs-cTnT与CK-MB联合检测诊断AMI的敏感度为47.6%,特异度为81.0%;3～6h组H-FABP与hs-cTnT联合检测诊断AMI的敏感度为94.7%、特异度为90.3%,hs-cTnT与CK-MB联合检测诊断AMI的敏感度为77.6%,特异度为83.9%。在灵敏度方面两者比较差异有统计学意义(P<0.05)。结论 H-FABP在AMI早期诊断中是较灵敏的指标,中晚期诊断时hs-cTnT敏感度和特异度优于H-FABP。在AMI早期诊断中,H-FABP与hs-cTnT联合检测的敏感度优于传统的hs-cTnT与CK-MB联合检测。Objective To investigate the value of H-FABP with hs-cTnT combination detection in early diagnosis of acute myocardial infarction（AMI）. Methods 380 patients admitted in hospital with acute chest pain were enrolled in the study. The patients were divided into three group according to the onset time of chest pain.〈3 h,3-6 h and 〉6h. In each group, H-FABP,hs-cTnT, CK-MB levels were detected. The sensitivity, specificity, positive predictive value and negative predictive value were compared of AMI among the three biomarkers,and the sensitivity, specificity, positive predictive value and negative predictive value were com- pared of AMI of combination detection of H-FABP and hs-cTnT were compared with that of hs-cTnT and CK-MB at the onset time of chest pain 〈6 h. Results There were significant statistical difference among these three biomarkers in patients with chest pain onset within 3 hours（P〈0.05）. Hs-cTnT was significantly higher than that of H-FABP in sensitivity and specificity in patients with chest pain onset more than 6 hours（P〉0.05）. The sensitivity of H-FABP with hs-cTnT and hs-cTnT with CK-MB were 91. 5% and 47.6% in patients with chest pain onset within 3 hours. The specificity were 83.3% and 81.0%. The sensitivity of HFABP with hs-cTnT and hs-cTnT with CK-MB were 94.7% and 77.6%in patients with chest pain onset between 3 and 6 hours. The specificity were 90.3 % and 83.9 %. There were significant statistical difference（P〈0.05）in sensitivity, while there were no significant statistical difference（P〉0.05）in specificity. Conclusion H-FABP in the early diagnosis of AMI was a more sensitive in- dex,while in the middle and late diagnosis,the sensitivity and specificity of hs-cTnT was superior to H-FABP. Combination detection of H-FABP and the hs-cTnT in the early diagnosis of AMI in the sensitivity was superior to traditional hs-cTnT and CK-MB combination detection.

关 键 词：心肌梗死 载体蛋白质类 生物学标记 早期诊断 

分 类 号：R542.22[医药卫生—心血管疾病]