心型脂肪酸结合蛋白与急性冠脉综合征患者冠状动脉病变程度的关系  

Relationship between serum concentration of heart-type fatty acid binding protein and severity of coronary artery lesion in patients with acute coronary syndrome

作　　者：王亚蓉[1,2] 郭壮波[1,2] 黄丽萍[1,2] 徐元杰[1,2] 

机构地区：[1]暨南大学医学院附属第四医院 [2]广州市红十字会医院心内科,广州510220

出　　处：《岭南心血管病杂志》2013年第4期405-408,共4页South China Journal of Cardiovascular Diseases

基　　金：2009年广东省科技计划项目(项目编号:2009B060700017);2008年广州市卫生科技项目立项(项目编号:2008-YB-039)

摘　　要：目的探讨心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)与近期发作急性冠脉综合征患者的冠状动脉病变严重程度的相关性及原因分析。方法入选暨南大学医学院附属第四医院急性冠脉综合征(发作12 h内)患者168例,其中急性心肌梗死86例、不稳定型心绞痛82例。采用双抗体夹心酶联免疫吸附试验(ELISA)法检测血清H-FABP、肌钙蛋白(cardiac troponin T,CTnT)及肌酸磷酸激酶同工酶(creatine phosphokinase isoenzyme,CK-MB)浓度。采用Gensini积分系统对冠状动脉血管病变狭窄程度、病变部位及范围进行定量评定。比较急性心肌梗死组与不稳定型心绞痛组血清H-FABP浓度及冠状动脉病变Gensini积分;比较Gensini积分、冠状动脉狭窄程度、病变支数亚组之间H-FABP浓度;采用直线回归分析方法分析血清H-FABP浓度与冠状动脉病变严重程度、血清cTnT浓度、血清CK-MB浓度的相关性。结果急性心肌梗死组血清H-FABP浓度显著高于不稳定型心绞痛组,差异有统计学意义[(88.5±32.9)pg/mL vs.(14.3±5.4)pg/mL,P<0.01]。随着冠状动脉狭窄程度加重、累及支数增加及Gensini积分增加,血清H-FABP浓度显著升高,差异有统计学意义(P<0.05)。血清H-FABP浓度与cTnT(r=0.627,P<0.05)及CK-MB(r=0.530,P<0.05)具有相关性;与患者冠状动脉病变严重程度呈正相关(r=0.538,P<0.01),其相关系数高于cTnT与冠状动脉病变严重程度的相关性(r=0.385,P<0.05)。结论血清H-FABP浓度升高反映了冠状动脉病变严重程度,临床可根据血清H-FABP浓度升高推断冠状动脉病变的严重程度,并采取积极的治疗措施。Objectives To study the correlation between serum concentration of heart-type fatty acid binding protein （H- FABP） and severity of coronary artery lesion in patients with acute coronary syndrome. Methods Serum concentrations of H-FABP, cardiac troponin T （cTnT） and creatine phosphokinase isoenzyme （CK-MB） were determined by enzyme linked immunosorbent assay （ELISA） in 86 patients with acute myocardium infarction （AMI） and 82 patients with unstable angina pectoris （UAP） in The Fourth Affiliated Hospital of Medical College. According to Gensini scoring system, severity, location and area of vascular stenosis were evaluated. Serum concentrations of H-FABP and Gensini scores between AMI group and UAP group were compared. Serum concentrations of H-FABP among subgroups for Gensini score, severity of coronary artery lesion and artery lesion were also compared. Relationships between serum concentration of H-FABP, severity of coronary artery lesion, cTnT and CK-MB were analyzed. Results Serum concentration of H-FABP in AMI group was significantly higher than that in UAP group [ （88.5-＋32.9） pg/mL vs. （14.3-＋5.4） pg/mL, P〈0.01 ]. Serum concentration of H-FABP obviously elevated as severity of coronary artery lesion, amount of artery lesion and Gensini scores increased （P〈O.05）. Serum concentration of H-FABP was positively correlated with cTnT （r=0.627, P〈O.05）, CK-MB （r=0.530, P〈0.05） and severity of coronary artery lesion （r=0.538 ,P〈0.01 ）. The correlation coefficient was higher than that of cTnT and severity of coronary artery lesion （r=0.385,P〈0.05）. Conclusions The severity of coronary stenosis can be reflected by concentration of H-FABP. Coronary artery lesions can be estimated by the elevated serum concentration of H-FABP.

关 键 词：冠状动脉疾病 心型脂肪酸结合蛋白 冠状动脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]