心脏型脂肪酸结合蛋白和缺血修饰蛋白在急性心肌梗死诊断中的应用价值  

作　　者：毛丽萍[1] 吴寿军 洪沐汉 

机构地区：[1]浙江省浦江县人民医院,322200

出　　处：《浙江临床医学》2014年第10期1532-1533,共2页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨心脏型脂肪酸结合蛋白（H-FABP）、缺血修饰蛋白（IMA）联合肌酸激酶同工酶MB（CK-MB）和肌钙蛋白I（cTnI）在急性心肌梗死（AMI）早期诊断中的应用价值。方法采用免疫层析法检测H-FABP和cTnI、白蛋白-钴离子结合试验检测IMA、免疫透射比浊法检测CK-MB。结果 AMI发病3h时的H-FABP、IMA、CK-MB和CTnI的阳性率分别为82.4%、75.0%、29.4%和20.6%，6h时分别为92.6%、85.3%、64.7%和48.5%，9h时分别为60.3%、67.6%、80.9%和75.0%；AMI发病3-6 h时H-FABP和IMA检出率高，9h以后CK-MB和CTnI检出率高；四项联合检测，灵敏性、特异性、阳性预测值及阴性预测值达95.6%、96.0%、98.5%和88.9%。结论 H-FABP和IMA在早期诊断AMI中有重要临床意义，四项联合检测可以提高早期诊断率。Objective To explore the value of joint detection H-FABP,IMA,CK-MB and cTnI in diagnosis of acute myocardial infarction. Methods H-FABP and cTnI were detected by immune chromatography,IMA was detected by albumincobaltions combined,CK-MB was detected by immune transmission turbidimetry. Results The sensitivity value were 82.4%75.0% 29.4% and 20.6% for H-FABP、IMA、CK-MB and CTnI at 3 hours,that were 92.6%、85.3%、64.7 % and 48.5% at 6 hours,that were 60.3%、67.6%、80.9%and 75.0%at 9 hours. It was high detection rate of H-FABP and IMA in 3-6h,it was high detection rate of CK-MB and CTnI after 9h. The sensitivity,specificity,positive predictive value and negative predictive value in AMI diagnosis were 95.6%、96.0%、98.5%and 88.9%. Conclusion H-FABP and IMA have important clinical significance in early diagnosis of AMI.Four joint detection can improve the detection rate and reduce the misdiagnosis and missed diagnosis.

关 键 词：心脏型脂肪酸结合蛋白 缺血修饰白蛋白 急性心肌梗死 

分 类 号：R542.2[医药卫生—心血管疾病]