血清心脏型脂肪酸结合蛋白检测在急性中毒早期严重程度分级中的价值研究  

Value of serum H-FABP as a marker of early severity classification in patients with acute poisoning

作　　者：王玺凯 刘媛[1] 房怡君 王琳[1] 马景晶 杜永锋[1] WANG Xikai;LIU Yuan;FANG Yijun

机构地区：[1]西安市中心医院职业病科

出　　处：《陕西医学杂志》2019年第12期1725-1728,共4页Shaanxi Medical Journal

基　　金：陕西省重点研发计划项目(2017SF-253)

摘　　要：目的:研究血清心脏型脂肪酸结合蛋白(H-FABP)含量在急性中毒患者早期严重程度分级中的临床意义。方法:收集资料齐全的急性中毒患者178例,按中毒严重程度分为轻度组、中度组和重度组,并进行急性生理学及慢性健康状况评分(APACHEⅡ);另选取同期健康体检者50例作为正常对照组。各组均检测血清H-FABP含量,统计分析各组血清H-FABP和APACHEⅡ评分,及其两者相关关系,并采用受试者工作特征曲线(ROC)评估H-FABP在急性中毒严重程度分级中的价值。结果:重度组血清H-FABP和APACHEⅡ评分明显高于正常组、轻度组和中度组(P<0.05),血清H-FABP与APACHEⅡ评分呈正相关(r=0.515,P<0.001),ROC曲线显示,血清H-FABP评估急性中毒轻中重度的最佳临界值分别为2.19ng/ml、2.81ng/ml和15.00ng/ml。结论:血清H-FABP含量随急性中毒严重程度分级的提高而升高,可将其作为临床评估急性中毒患者早期严重程度分级的标志物。Objective:To study the clinical significance of serum heart-type fatty acid binding protein(H-FABP) in the early severity classification of acute poisoning patients. Methods:178 patients with acute poisoning were analyzed. They were divided into mild,moderate and severe groups according to the severity of poisoning. Acute physiology and chronic health status(APACHE II) were scored. Another 50 healthy people in the same period were selected as normal control group.Serum H-FABP levels were measured in each group. Serum H-FABP and APACHEE II scores of each group were analyzed and their correlation was analyzed. The value of H-FABP in severity classification of acute poisoning was evaluated by ROC curve. Results:Serum H-FABP and APACHE II scores in severe group were significantly higher than those in normal group,mild group and moderate group(P<0.05). Serum H-FABP was positively correlated with APACHE II scores(r=0.515,P<0.001).ROC curve analysis showed that the optimal critical values of serum H-FABP for assessing the severity of acute poisoning were 2.19 ng/ml,2.81 ng/ml and 15.00 ng/ml,respectively. Conclusion:Serum H-FABP content increased with the increase of severity grade of acute poisoning,which can be used as a marker for clinical evaluation of early severity grade of acute poisoning patients.

关 键 词：心脏型脂肪酸结合蛋白 分级标志物 急性中毒 受试者工作特征曲线 

分 类 号：R595[医药卫生—内科学]