H-FABP联合cTnI、CK、Mb、CK-Mb检测在ACS早期诊断中的价值  

The value of heart-type fatty acid-binding protein and cTnI、 CK、Mb、CK-Mb in early ACS

作　　者：谢明水[1] 刘国政[1] 李玲[1] 敖晶晶[1] 刘杨[1] 张振建[2] 

机构地区：[1]随州市中心医院检验科,湖北随州441300 [2]随州市中心医院心血管内科

出　　处：《临床急诊杂志》2013年第12期596-598,共3页Journal of Clinical Emergency

基　　金：湖北省卫生厅资助项目(No:2009JX4B69)

摘　　要：目的:探讨H-FABP与cTnI、CK、Mb、CK-Mb联合检测在急性冠脉综合征患者诊断中的临床价值。方法:采用ELISA法检测81例6h内胸痛发作患者的血清H-FABP水平,采用免疫荧光法测定这些患者血清中的cTnI、CK、Mb、CK-Mb,其中急性心肌梗死(AMI)30例、不稳定型心绞痛(UAP)26例、非心源性胸痛(NCCP)25例,同期选择27例健康体检者为对照组。应用Logistic回归模型绘制ROC曲线并计算曲线下面积(AUC)来评估H-FABP的诊断价值。结果:AMI组的H-FABP水平(73.35±56.73)μg/L最高,UAP组(13.50±5.64)μg/L次之(P<0.01);NCCP组(4.07±3.27)μg/L与对照组(3.42±1.53)μg/L比较差异无统计学意义(P>0.05)。H-FABP诊断AMI敏感性(96.7%)明显优于cTnI诊断敏感性74.5%(P<0.05);H-FABP与cTnI联合检测ROC曲线下面就更高达0.908。结论:H-FABP与cTnI联合检测可为急性冠脉综合征患者的诊断提供依据。Objective：To investigate the clinic value of serum heart-type fatty acid-binding protein and cTnl, CK,Mh,CK Mb on prognosis of patients with acute coronary syndrme. Method：The H-FABP level was measured within 6h after onset of chest pain in 81 patients by ELISA methods and cTnI,CK,Mb,CK-Mb by immunofluoresent assays. With 30 cases of acute myocardial infarction （AMI）, 26 cases of unstable angina pectoris （UAP）, 25 cases of non cardiac chest pain （NCCP）, at the same period 27 healthy volunteers were selected as the control group. H-FABP diagnosis value is evaluated by the area under the concentration-time curve of receiver operating characteristic rendered using Logistic regression model. Result：The H-FABP level （73.35 ± 56.73） μg/L in AMI group was highest,and the H FABP level （13.50±5.64） μg/L in UAP group was higher （P〈0.01）. There was no statistically significant between NCCP group （4.07 ± 3.27） μg/L and the control group （3.42 ± 1.53）μg/L. The sensitivity of H-FABP on diagnosis of AMI （96.7 % ） was significantly better than that of cTnI （80%）（P〈 0.05） ,comparison of specific between the two had no significant difference. The area under the concentration-time curve of receiver operating characteristic of H FABP and cTnI is up to 0. 908. Conclusion： The H-FABP and cTnI level could be diagnostic basis for acute coronary syndrme.

关 键 词：冠状动脉疾病 急性冠脉综合征 联合检测 

分 类 号：R541.4[医药卫生—心血管疾病]