缺血性修饰白蛋白、心型脂肪酸结合蛋白、可溶性生长刺激表达基因2蛋白与GRACE评分联合检测对急性冠状动脉综合征的早期诊断价值  

The combined value of IMA,H-FABP,soluble ST2 and GRACE score in the early diagnosis of acute coronary syndrome

作　　者：郑毅华 陈晓丹 伍慧妍[1] 詹铀超[1] Zheng Yihud;Chen Xiaodan;Wu Huiyan;Zhan Youchao(Department of clinical Laboratory,The Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510700,China;KingMed School of Laboratory Medicine,Guangzhou Medical University,Guangzhou Guangdong 510180,China)

机构地区：[1]广州医科大学附属第五医院检验科,广东广州510700 [2]广州医科大学金域检验学院,广东广州510180

出　　处：《中华临床实验室管理电子杂志》2023年第1期10-15,共6页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

基　　金：广东省医学科学技术研究基金项目(B2021440)。

摘　　要：目的:探讨缺血性修饰白蛋白(IMA)、心型脂肪酸结合蛋白(H-FABP)、可溶性生长刺激表达基因2蛋白(sST2)与全球急性冠状动脉事件注册(GRACE)评分联合检测对急性冠状动脉综合征(ACS)的早期诊断价值。方法:本研究纳入2021年7月至2022年2月接受治疗的100例ACS患者(观察组)和同期100例健康体检者(对照组),采用乳胶增强免疫比浊法检测血清IMA和H-FABP浓度,采用免疫荧光干式定量法测定血清sST2浓度,利用全球急性冠状动脉事件注册(GRACE)风险评分危险分层将观察组患者分为低危组、中危组和高危组,对比3组患者血清IMA、H-FABP及sST2水平,分析3种检测指标与GRACE评分的关系。通过制作受试者工作特征曲线(ROC),评价各种检测指标的特异性和敏感度,分析3种检测指标及联合检测与GRACE评分用于ACS早期诊断的价值。结果:观察组患者血清IMA、H-FABP及sST2水平均高于对照组(均P<0.05)。3组血清IMA及sST2水平比较,差异无统计学意义(P>0.05),而低危组与高危组H-FABP水平比较,差异有统计学意义(P<0.05)。相关性分析显示,血清IMA、H-FABP及sST2水平与GRACE评分呈无相关(r=-0.028,P=0.785;r=-0.011,P=0.910;r=-0.046,P=0.65)。ROC曲线显示,IMA、H-FABP及sST2具有较好的特异性(89%~96%),但只有一般的敏感性(54%~76%)。而三者联合检测具有较好的辅助诊断ACS效能(AUC为0.962,敏感度性92%,特异性为94%),高于各项指标单独检测。结论:早期ACS患者血清IMA、H-FABP、sST2水平呈异常升高状态,且三者与GRACE评分呈无相关。但同时联合三者进行诊断能够提高ACS的诊断效能,对ACS患者的早期诊断具有一定意义。Objective To explore the early diagnostic value of ischemic modified albumin(IMA),heart-type fatty acid binding protein(H-FABP),soluble growth stimulation expression gene 2 protein(sST2)and GRACE score for acute coronary syndrome(ACS).Methods One hundred patients with ACS treated from July 2021 to February 2022 were enrolled in this study.Serum IMA and H-FABP concentrations were measured by latex-enhanced immunodeficiency,and serum sST2 concentration was measured by immunofluorescence dry quantification.The levels of serum IMA,H-FABP and sST2 in the three groups were compared,and the patients were divided into low-risk group,medium-risk group and high-risk group according to the risk stratification of the Global Registry of Acute Coronary Events(GRACE).The relationship between GRACE score and the three indicators was analyzed.The receiver operating characteristic curve(ROC)was used to evaluate the specificity and sensitivity of each index,and to analyze the relationship between the three indexes and ACS.Results The serum levels of IMA,H-FABP and sST2 in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in serum IMA,H-FABP and sST2 levels were compared among three groups,and it was elevated in the low-risk state.Correlation analysis showed that serum IMA,H-FABP and sST2 levels were not correlated with GRACE score(r=-0.028,P=0.785;r=-0.011,P=0.910;r=-0.046,P=0.65).The ROC curve showed that IMA,H-FABP and sST2 had good specificity(89%~96%),but only general sensitivity(54%~76%).The combined detection of the three indexes had a better auxiliary diagnostic efficacy for ACS(AUC=0.962,sensitivity-92%,specificity=94%),which was significantly higher than the individual detection of each index.Conclusions The serum levels of IMA,H-FABP and sST2 are abnormally elevated in patients with early ACS,and they are not correlated with GRACE score.However,the combination of the three methods can improve the diagnostic efficiency of ACS,and has certain signific

关 键 词：缺血性修饰白蛋白 心型脂肪酸结合蛋白 可溶性生长刺激表达基因2蛋白 急性冠状动脉综合征 全球急性冠状动脉事件注册评分 

分 类 号：R541.4[医药卫生—心血管疾病]