超声心动图联合H-FABP在心肌梗死患者左心功能评估中的应用价值  

Value of echocardiography combined with H-FABP in assessment of left ventricular function in patients with myocardial infarction.

作　　者：肖春红[1] 刘米莉 申良红[1] 吴长东[1] 陈玲[2] XIAO Chun-hong;LIU Mi-li;SHEN Liang-hong(Emergency Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830000,China.)

机构地区：[1]新疆维吾尔自治区人民医院急救中心,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院老年医学中心,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2021年第17期1834-1838,共5页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区自然科学基金项目(编号:2020D01C106);新疆维吾尔自治区人民医院院内项目(编号:20200303)。

摘　　要：目的检测心肌梗死(MI)患者超声心动图及心肌型脂肪酸结合蛋白(H-FABP)水平,并分析其在患者左心室功能评估中的应用价值。方法回顾性选取2018年9月至2020年9月新疆维吾尔自治区人民医院收治的MI患者126例为研究对象,纽约心脏病协会(NYHA)心功能分级:Ⅰ级60例,Ⅱ级66例。选取健康体检者60例为对照组。检测各组受试者的血压、血清丙氨酸氨基转移酶(ALT)、肌酐(CRE)、尿素氮(BUN)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)等水平。对各组受试者进行心脏超声心动图检查,计算得出左室收缩末容积(LVESV)、左心每博输出量(LVSV)、左室舒张末容积(LVEDV)以及左室射血分数(LVEF)。采用胶体金法检测技术检测血清H-FABP水平。分析血清H-FABP水平与超声心动图指标相关性,评估血清H-FABP水平、LVEF对MI患者心功能的诊断价值。结果MI组与对照组性别构成比、年龄、吸烟人数、血压、血清ALT、CRE、BUN、TC、TG、HDL、LDL水平差异均无统计学意义(P>0.05)。与对照组比较,NYHAⅠ级、Ⅱ级组患者LVEF显著降低,LVSV、LVEDV、LVESV、血清H-FABP水平显著升高(P<0.05);与NYHAⅠ级组患者比较,Ⅱ级组患者LVEF显著降低,LVSV、LVEDV、LVESV、血清H-FABP水平显著升高(P<0.05);血清H-FABP水平与超声心动图左心室功能指标LVEF负相关(P<0.05),与LVSV、LVEDV、LVESV显著正相关(P<0.05);血清H-FABP水平及LVEF对MI患者心功能NYHAⅡ级的评估具有一定价值,二者联合检测评估MI患者心功能NYHAⅡ级的AUC为0.982,灵敏度为96.70%,特异度为95.50%。结论MI患者LVEF降低,LVSV、LVEDV、LVESV升高,血清H-FABP水平升高,LVEF及H-FABP水平联合对MI患者心功能评估具有一定价值。Objective To detect the echocardiographic and myocardial fatty acid binding protein(H-FABP)level in patients with myocardial infarction(MI),and to analyze their application values in evaluating left ventricular function.Methods A total of 126 MI patients admitted to People's Hospital of Xinjiang Uygur Autonomous Region from September 2018 to September 2020 were selected as the study subjects.New York Heart Association(NYHA)cardiac function grading:60 cases of gradeⅠand 66 cases of gradeⅡ.60 healthy persons were selected as the control group.Blood pressure,serum alanine aminotransferase(ALT),creatinine(CRE),urea nitrogen(BUN),triglyceride(TG),cholesterol(TC),low density lipoprotein cholesterol(LDL)and high density lipoprotein cholesterol(HDL)of each group were measured.They were examined by echocardiography,and left ventricular end systolic volume(LVESV),left heart volume per stroke(LVSV),left ventricular end diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)were calculated.The level of serum H-FABP was detected by colloidal gold assay.The correlation between serum H-FABP level and echocardiographic indicators was analyzed,and the diagnostic value of serum H-FABP level and LVEF for MI patients'cardiac function was evaluated.Results There were no significant differences in sex,age,smoking number,blood pressure,serum ALT,CRE,BUN,TC,TG,HDL and LDL levels between MI group and control group(P>0.05).Compared with the control group,the LVEF of NYHA groupⅠandⅡdecreased significantly,while LVSV,LVEDV,LVESV and serum H-FABP levels increased significantly(P<0.05).Compared with NYHA groupⅠ,the LVEF of groupⅡwas significantly lower,while LVSV,LVEDV,LVESV and serum H-FABP levels increased significantly(P<0.05).Serum H-FABP level was negatively correlated with LVEF of echocardiography(P<0.05),and positively correlated with LVSV,LVEDV and LVESV(P<0.05).Serum H-FABP level and LVEF had certain value in evaluating NYHAⅡgrade of cardiac function in MI patients,the AUC of NYHA classⅡin MI patients was

关 键 词：心肌梗死 超声心动图 心肌型脂肪酸结合蛋白 左心功能 

分 类 号：R542.22[医药卫生—心血管疾病] R540.45[医药卫生—内科学]