H-FABP定性检测对老年急性心肌梗死的诊断价值  

VALUE OF QUALITATIVE DETECTION OF HEART-TYPE FATTY ACID-BINDING PROTEIN IN DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION IN THE ELDERLY

作　　者：刘嫦玉[1] 吴丽婷[1] 苏屿[1] LIU Changyu;WU Liting;SU Yu(Department of Laboratory,Hainan Provincial People’s Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院检验科

出　　处：《青岛大学学报（医学版）》2019年第6期722-725,共4页Journal of Qingdao University(Medical Sciences)

基　　金：海南省自然科学基金项目(2016812173)

摘　　要：目的探讨心脏型脂肪酸结合蛋白(H-FABP)用于诊断老年急性心肌梗死的临床价值。方法选取我院2015年10月—2017年6月收治的92例急性胸痛老年病人,经临床诊断48例为急性心肌梗死病人,44例为非急性心肌梗死病人。病人发病6 h内和发病6 h后分别检测H-FABP、肌钙蛋白(cTn)和肌酸激酶同工酶(CK-MB)。比较发病不同时间各检测指标诊断急性心肌梗死的灵敏度和特异度。结果病人发病6 h内,H-FABP、cTn、CK-MB检测诊断急性心肌梗死的灵敏度分别为95.8%、72.9%和77.1%,特异度分别为100.0%、79.5%和77.3%,H-FABP的灵敏度和特异度均高于cTn、CK-MB(χ^2=9.669、11.190,P<0.01)。病人发病6 h后,H-FABP、cTn、CK-MB检测诊断急性心肌梗死的灵敏度分别为100.0%、97.9%、93.8%,特异度分别为95.5%、93.2%、88.6%,各检测指标的灵敏度和特异度比较差异均无统计学意义(P>0.05)。H-FABP、cTn、CK-MB在发病6 h内诊断急性心肌梗死的受试者工作特征曲线的曲线下面积分别为0.893、0.807、0.682,H-FABP大于cTn和CK-MB。结论H-FABP检测诊断急性心肌梗死具有较高的灵敏度和特异度。病人发病6 h以内,H-FABP检测诊断急性心肌梗死灵敏度和特异度比cTn、CK-MB检测高,有较高的早期诊断价值。Objective To investigate the clinical value of heart-type fatty acid-binding protein(H-FABP)in the diagnosis of acute myocardial infarction(AMI)in the elderly.Methods A total of 92 elderly patients with acute chest pain who were admitted to our hospital from October 2015 to June 2017 were enrolled,and among them,48 were diagnosed with AMI and 44 were diagnosed with non-AMI diseases.H-FABP,cardiac troponin(cTn),and creatine kinase-MB(CK-MB)were measured within 6 h after onset and at 6 h after onset.The above indices at different time points were compared in terms of sensitivity and specificity in the diagnosis of AMI.Results Within 6 h after onset,H-FABP,cTn,and CK-MB had a sensitivity of 95.8%,72.9%,and 77.1%,respectively,and a specificity of 100.0%,79.5%,and 77.3%,respectively,in the diagnosis of AMI,and H-FABP had significantly higher sensitivity and specificity than cTn and CK-MB(χ^2=9.669,11.190;P<0.01).At 6h after onset,H-FABP,cTn,and CK-MB had a sensitivity of 100.0%,97.9%,and 93.8%,respectively,and a specificity of 95.5%,93.2%,and 88.6%,respectively,in the diagnosis of AMI,and there were no significant differences in sensitivity and specificity between the three indices(P>0.05).In the diagnosis of AMI within 6 h after onset,H-FABP,cTn,and CK-MB had an area under the receiver operating characteristic curve(AUC)of 0.893,0.807,and 0.682,respectively,and H-FABP had a higher AUC than cTn and CK-MB.Conclusion Qualitative detection of H-FABP has high sensitivity and specificity in the diagnosis of AMI.Within 6 h after onset,H-FABP has higher sensitivity and specificity than cTn and CK-MB and thus has a high value in early diagnosis.

关 键 词：脂肪酸结合蛋白质类 肌钙蛋白 肌酸激酶 MB型 心肌梗死 老年人 诊断 

分 类 号：R446.1[医药卫生—诊断学] R542.22[医药卫生—临床医学]