早期心型脂肪酸结合蛋白与血栓弹力图联合检测对急性心肌梗死预后的评估价值  

Value of early detection combined detection of heart-type fatty acid binding protein and thromboelastography in early evaluating prognosis of acute myocardial infarction

作　　者：金慧[1] 乌日娜[1] JIN Hui;WU Ri-na(Department of Cardiovascular Medicine,Baotou Central Hospital,Inner Mongolia Baotou,014040)

机构地区：[1]内蒙古自治区包头市中心医院心血管内科

出　　处：《中国医刊》2020年第2期155-158,共4页Chinese Journal of Medicine

基　　金：内蒙古自治区科技厅计划项目（20080502）

摘　　要：目的探究早期心型脂肪酸结合蛋白(heart-type fatty acid binding protein,h-FABP)与血栓弹力图联合检测对急性心肌梗死预后的评估价值。方法选择2015年2月至2017年12月包头市中心医院心血管内科收治的急性心肌梗死早期行h-FABP及血栓弹力图检测的患者176例,依据随访12个月是否发生主要心血管不良事件(major adverse cardiovascular events,MACE)分为MACE组(47例)和无MACE组(129例),比较两组患者h-FABP水平和血栓弹力图参数R、α角、MA值、CI水平,分析h-FABP水平和血栓弹力图参数与急性心肌梗死预后的关系。结果两组一般资料比较差异无显著性(P>0.05);两组h-FABP及血栓弹力图参数R、α角、MA值、CI水平比较差异有显著性(P<0.05);ROC曲线分析显示,h-FABP与血栓弹力图参数R、α角、MA值、CI单一项的曲线下面积分别为0.923、0.736、0.843、0.785、0.643,各指标最佳截断点分别为75.36μg/L、5.34min、68.63ο、64.37mm、1.39。h-FABP与血栓弹力图联合检测时曲线下面积为0.962;联合h-FABP与血栓弹力图评估MACE的敏感度为95.74%,特异度为96.90%,阳性预测值为91.94%,阴性预测值为98.43%,准确率为96.59%。结论早期联合检测h-FABP与血栓弹力图对急性心肌梗死预后有很好的预测价值。Objective To evaluate the value of early detection combined detection of heart-type fatty acid binding protein(h-FABP)and thromboelastography(TEG)in early evaluating prognosis of acute myocardial infarction(AMI).Method Totally 176 cases who were tested h-FABP,TEG in the early stage of AMI were divided into MACE group(47 cases)and non-MACE group(129 cases)according to the occurence of major adverse cardiovascular events(MACE)within 12 months of follow-up.To analyze the relationship between h-FABP,TEG(parameters:R,αangle,MA value,CI)and prognosis of AMI.Result There was no significant difference in general data between the two groups(P>0.05);There were significant differences in h-FABP and TEG parameters R,αangle,MA value and CI level between the two groups(P<0.05);ROC curves showed that the underlying areas of h-FABP and R,αangle,MA value and CI were 0.923,0.736,0.843,0.785 and 0.643,respectively,and the best cut-off points of each index were 75.36μg/L,5.34min,68.63ο,64.37mm,1.39,respectively.AUC was 0.962 when combined detection of h-FABP and TEG.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of combined h-FABP and TEG in evaluating MACE were 95.74%,96.90%,91.94%,98.43%and 96.59%,respectively.Conclusion Early detection h-FABP combined TEG has a good predictive value for the prognosis of AMI.

关 键 词：急性心肌梗死 心型脂肪酸结合蛋白 血栓弹力图 评估预后 

分 类 号：R542.22[医药卫生—心血管疾病]