联合检测心型脂肪酸结合蛋白、和肽素及肌钙蛋白T对非ST段抬高型急性心梗的早期诊断价值  

Diagnostic value of the combination of heart-type fatty acid-binding protein,copeptin and cardiac troponin T in patients with non-ST-segment elevation myocardial infarction

作　　者：李敏[1] 陈锋[1] 王建伟[2] LI Min;CHEN Feng;WANG Jianwei(Department of Emergency , Fujian Provincial Hospital,Provincial Clinical College of Fujian Medical University,Fuzhou, Fujian 350001, China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院急诊科,福州350001 [2]福建省立医院南院检验科

出　　处：《福建医药杂志》2018年第6期25-28,共4页Fujian Medical Journal

摘　　要：目的研究心型脂肪酸结合蛋白(H-FABP)、和肽素(copeptin)与肌钙蛋白T (cTnT)联合检测对非ST段抬高型心肌梗死(NSTEMI)早期诊断的价值。方法收集急诊胸痛患者111例,均于胸痛3h内入院,其中非ST段抬高型急性心梗(NSTEMI)58例、心绞痛(AP)22例、非心源性胸痛(NCCP)31例,检测血清H-FABP、和肽素、cTnT、肌钙蛋白I (cTnI)、肌酸激酶同工酶(CKMB),比较组间差异。NSTEMI患者按照Gensini评分分为低分组14例,中分组19例,高分组25例,比较上述指标的组间差异。根据ROC曲线判断各指标对NSTEMI早期诊断的效能。结果联合检测H-FABP、和肽素与cTnT在NSTEMI早期诊断中有着较高的敏感度(71.1%)及特异度(72.6%),曲线下面积为0.729,高于cTnT、cTnI及CKMB (P<0.05)。结论联合检测H-FABP、和肽素与cTnT对NSTEMI的早期诊断效能优于cTnT、cTnI及CKMB,也对冠脉病变程度的评估具有一定临床指导意义。Objective To study the prognostic value of the combination of heart-type fatty acid-binding protein(HFABP),copeptin and cardiac troponin T(cTnT)in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods A total of 111 patients treated in our department due to chest pain within three hours were recruited,including 58 cases of NSTEMI,22 cases of AP and 31 cases of NCCP.H-FABP,copeptin,cTnT,cTnI and CKMB were measured in all patients.According to Gensini scoring system for quantitative determination of each vascular lesions,the patients with NSTEMI were divided into three groups:low score group(14 cases),middle score group(19 cases),and high score group(25 cases).According to ROC curve,the efficacy of each index in the early diagnosis of NSTEMI was determined.Results The combination of H-FABP,copeptin and cTnT showed higher detection sensitivity(71.1%),specificity(72.6%).The AUC of joint detection increased significantly(P<0.05)compared to that of cTnT,cTnI and CKMB.Conclusion The combination of H-FABP,copeptin and cTnT shows better diagnosis efficiency of NSTEMI than cTnT,cTnI and CKMB,and also reflects the severity of coronary artery disease.

关 键 词：心型脂肪酸结合蛋白 和肽素 肌钙蛋白T 非ST段抬高型心肌梗死 

分 类 号：R542.2[医药卫生—心血管疾病]