缺血修饰白蛋白与心脏型脂肪酸结合蛋白联合检测对不典型急性心肌梗死患者的早期诊断价值  

Early Diagnostic Value of IMA and H-FABP in Patients with Atypical Acute Myocardial Infarction

作　　者：周拥志[1] 彭筱平[1] Zhou Yongzhi;Peng Xiaoping(Department of Cardiovascular Medicine,The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine,Zhuzhou,Hunan,412000,China)

机构地区：[1]湖南中医药高等专科学校附属第一医院·湖南省直中医医院心血管内科,湖南株洲412000

出　　处：《黑龙江医学》2024年第13期1561-1563,共3页Heilongjiang Medical Journal

基　　金：湖南省卫生计生委科研计划课题项目(C2016004)。

摘　　要：目的:探讨缺血修饰白蛋白(IMA)与心脏型脂肪酸结合蛋白(H-FABP)联合检测对不典型急性心肌梗死(AMI)患者的早期诊断价值。方法:选择2021年1月—2022年6月湖南中医药高等专科学校附属第一医院收治的发病6 h内的176例可疑AMI患者作为研究对象,依照临床最终诊断结果将其分为有胸痛AMI组90例、无胸痛AMI组32例、非AMI组54例。选择同期在医院体检的30名健康者作为健康对照组。测定各组研究对象H-FABP、IMA、肌钙蛋白I(c TnI)及肌酸激酶同工酶(CK-MB)含量,计算H-FABP、IMA、H-FABP+IMA、cTnI、CK-MB对无胸痛AMI组患者的诊断性试验评价指标。结果:有胸痛AMI组及无胸痛AMI组患者IMA、H-FABP、cTnI、CK-MB水平均高于非AMI组患者及健康对照组研究对象,差异均有统计学意义(F=7.362、12.275、8.938、3.294、8.729、16.736、10.283、5.726,P<0.05);有胸痛AMI组患者与无胸痛AMI组患者IMA、H-FABP、cTnI、CK-MB水平比较,差异均无统计学意义(t=2.428、1.594、2.875、3.179,P>0.05)。IMA联合H-FABP检测诊断无胸痛AMI组患者的灵敏度、特异度、阳性预测值、阴性预测值、诊断效率均高于IMA、H-FABP、cTnI、CK-MB单独检测数据,差异均有统计学意义(χ^(2)=12.328、16.972、9.375、11.547,P<0.05)。结论:IMA与H-FABP联合检测对不典型AMI患者的早期诊断具有较高的临床价值。Objective:To investigate the early diagnostic value of ischemia modified albumin(IMA)and heart fatty acid binding protein(H-FABP)in patients with atypical acute myocardial infarction(AMI).Methods:176 patients with suspected acute myocardial infarction who came to the hospital within 6 hours from January 2021 to June 2022 were selected.According to the final clinical diagnosis results,they were divided into 90 cases in AMI group with chest pain,32 cases in AMI group without chest pain,and 54 cases in non AMI group.30 healthy people in the same period were selected as the healthy control group.The contents of H-FABP,IMA,cTnI and CK-MB in each group were measured,and the diagnostic test evaluation indexes of H-FABP,IMA,H-FABP+IMA,cTnI and CK-MB for AMI patients without chest pain were calculated.Results:The levels of H-FABP,IMA,cTnI and CK-MB in AMI group were significantly higher than those in non AMI group and healthy control group(F=7.362,12.275,8.938,3.294,8.729,16.736,10.283,5.726,P<0.05).The levels of H-FABP,IMA,cTnI and CK-MB in AMI group with chest pain and AMI group without chest pain had no significant difference(t=2.428,1.594,2.875,3.179;P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic efficiency of IMA combined with H-FABP in the diagnosis of AMI patients without chest pain were higher than those of IMA,H-FABP,cTnI and CK-MB alone,with statistically significant difference(χ^(2)=12.328,16.972,9.375,11.547;P<0.05).Conclusion:The combined detection of IMA and H-FABP is of high clinical value in the early diagnosis of atypical AMI patients.

关 键 词：急性心肌梗死 不典型 缺血修饰白蛋白 心脏型脂肪酸结合蛋白 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]