心型脂肪酸结合蛋白对老年患者开胸术后心血管事件的预测价值  

Relationship between heart-type fatty acid-binding protein and cardiovascular events after thoracic surgery in aged patients

作　　者：杨彬[1] 石坚[2] 熊卫民[1] 黄标通[1] 

机构地区：[1]解放军第一六三医院胸心外科,长沙410003 [2]解放军第一六三医院检验科,长沙410003

出　　处：《中国医师杂志》2016年第4期536-538,543,共4页Journal of Chinese Physician

基　　金：湖南省教育厅科学研究项目（13C552）

摘　　要：目的 探讨心型脂肪酸结合蛋白（H-FABP）对老年患者非心脏开胸术后心血管事件（PCE）的预测价值.方法 前瞻性选取2012年2月至2014年8月本院接受开胸手术的＞60岁的患者68例,对患者一般资料、术前术后H-FABP水平及PCE发生情况进行记录和分析.绘制H-FABP预测发生PCE的接受者操作特征曲线（ROC曲线）,评价其相关性.结果 共有18例患者发生PCE.心血管事件组术后H-FABP水平明显高于非心血管事件组（P＜0.05）,两组术前H-FABP水平差异无统计学意义（P＞0.05）.术后H-FABP和术前氮端脑钠肽前体（NT-proBNP）水平是开胸术后发生PCE的独立危险因素.术后H-FABP水平预测发生PCE曲线下面积为0.840（95％ CI：0.716～0.964,P＜0.01）,预测心血管事件发生的最佳界值为5.26 μg/L（OR 15.944,95％ CI：4.239～ 59.978,P＜0.01）,此时灵敏度77.8％,特异度84.0％.结论 术后H-FABP水平是老年开胸非心脏手术后PCE的独立危险因素,对PCE的发生具有较好的预测价值.Objective To explore the predictive value of heart-type fatty acid-binding protein （HFABP） in predicting the cardiovascular events after none-cardiac thoracic surgery in aged patients.Methods Sixty eight aged patients were admitted from February 2012 to August 2014 and accepted none-cardiac thoracic surgery.The patients＆#39;general information and the incidence of postoperational cardiovascular events were recorded.Serum H-FABP was measured.The receiver operating characteristic （ROC） curve was constructed and the predictive effect of serum H-FABP for prognosis was analyzed.Results Eighteen patients were suffered from postoperative cardiovascular events （PCE）.The level of H-FABP after surgery in patients with PCE was higher than that with none-PCE （P 〈 0.05）.The serum concentration of H-FABP after surgery and NT-proBNP before surgery was the independent risk factors for the elderly patients undergoing non-cardiac thoracic surgery.The area under ROC of H-FABP was 0.840 （95% CI：0.716 ～0.964,P 〈0.01）.The sensitivity and specificity of predicting postoperational cardiovascular event with serum concentration of H-FABP 〉5.26μg/L was 77.8% and 84.0% （OR 15.944,95% CI：4.239 ～59.978,P 〈0.01）.Conclusions The level of H-FABP after surgery is an independent risk factor for the occurrence of PCE for the elderly patients undergoing non-cardiac thoracic surgery.It can predict the risk of PCE after non-cardiac thoracic surgery in aged patients.

关 键 词：脂肪酸结合蛋白质类/代谢 胸廓切开术/副作用 心血管疾病/并发症/代谢 

分 类 号：R655[医药卫生—外科学]