h-FABP在检测脓毒症早期心肌损伤中的意义  

Significance of h-FABP in the detection of early myocardial injury in sepsis

作　　者：罗思文 张琳 LUO Siwen;ZHANG Lin(ICU,the Third Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学 [2]安徽医科大学第三附属医院重症监护室,安徽合肥230000

出　　处：《中国医药科学》2019年第5期89-91,95,共4页China Medicine And Pharmacy

摘　　要：目的观察心型脂肪酸结合蛋白(h-FABP)检测在脓毒症早期心肌损伤中的诊断价值。方法选取合肥市第一人民医院及滨湖医院2017年1月～2018年6月纳入符合《第三版脓毒症与感染性休克定义国际共识》中的诊断标准病例60例脓毒症患者;根据患者入院3h内超声心动图结果,以左心室射血分数(LVEF)≤50%提示合并心肌损伤,将患者分为心肌损伤组及非心肌损伤组各30例。分别检测入院3h,6h cTnI、CK-MB、心型脂肪酸结合蛋白(h-FABP)水平,绘制ROC受试者工作特征曲线,评价cTnI、CK-MB及h-FABP这三项指标对早期心肌损伤的诊断价值。结果入院3h心肌损伤组的CK-MB、cTnI、h-FABP高于心肌非损伤组,差异有统计学意义(t=2.084,3.568,11.451,P <0.05),入院6h cTnI、CK-MB、h-FABP值均高于心肌非损伤组差异有统计学意义(t=8.401,7.855,18.660,P <0.05),且6h组cTnI、CK-MB、h-FABP诊断心肌损伤的曲线下面积(AUC)分别为0.817,0.750,0.950。结论 h-FABP检测可进一步提高脓毒症早期心肌损伤诊断的敏感性,更好的预测脓毒症心肌损伤发生的风险,要优于传统的CK-MB、cTnI检测。Objective To evaluate the diagnostic value of heart fatty acid binding protein (h-FABP) in the detection of early myocardial injury in sepsis. Methods 60 patients with sepsis who were collected from the First People's Hospital of Hefei and Binhu Hospital from January 2017 to June 2018 and met the International Consensus on the Definition of Sepsis and Septic Shock (the third edition) were divided into the myocardial injury group and the nonmyocardial injury group, with 30 patients each. According to the results of echocardiography within 3 hours after admission, the left ventricular ejection fraction (LVEF) 50% was suggested to be associated with myocardial injury. cTnI, CK-MB and cardiac fatty acid binding protein (h-FABP) levels were detected at 3h and 6h after admission, and ROC subject working characteristic curves were drawn to evaluate the diagnostic value of cTnI, CK-MB and h-FABP on early myocardial injury. Results CK-MB, cTnI and h-FABP in the myocardial injury group were higher than those in the non-myocardial injury group within 3 hours upon admission, and the difference was statistically significant (t=2.084,3.568,11.451, P<0.05). The values of cTnI, CK-MB and h-FABP at 6 hours after admission were all higher than those in the non-myocardial injury group, and the difference was statistically significant (t=8.401,7.855,18.660, P<0.05), and the AUC of cTnI, CK-MB and h- FABP in the 6-hour group were 0.817, 0.750 and 0.950, respectively. Conclusion h-FABP detection can further improve the sensitivity of early diagnosis of septic myocardial injury and better predict the risk of incidence of septic myocardial injury, which is superior to the traditional cTnI and CK-MB detection.

关 键 词：脓毒症 心肌损伤 H-FABP CTNI CK-MB 

分 类 号：R278[医药卫生—中医学]