血清H-FABP、cTnI联合心电图对AMI的诊断价值  

Diagnostic value of serum H-FABP,cTnI and electrocardiogram for AMI

作　　者：高欢 孙震 郑海波 GAO Huan;SUN Zhen;ZHENG Hai-bo(Department of Cardiovascular Medicine,Hefei Eighth People's Hospital,Hefei,Anhui,238000,China)

机构地区：[1]合肥市第八人民医院心血管内科,安徽合肥238000

出　　处：《心血管康复医学杂志》2025年第1期71-76,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨血清心型脂肪酸结合蛋白(H-FABP)、心肌肌钙蛋白I(cTnI)联合心电图对急性心肌梗死(AMI)的诊断价值。方法:选择2018年3月-2020年3月于合肥市第八人民医院收治的120例胸痛疑似AMI患者,均行心电图检查及冠状动脉造影(CAG),根据诊断标准分为AMI组(n=75)与非AMI组(n=45),依据Gensini积分将AMI患者分为轻度组(n=34)、中重度组(n=41),另选择同期体检健康者120例为对照组。检测各组血清H-FABP、cTnI水平,采用ROC曲线评估H-FABP、cTnI、心电图单独及联合对AMI的诊断价值。结果:以CAG为金标准,心电图检测显示:120例胸痛疑似AMI患者中确诊62例,诊断准确度、灵敏度、特异度分别为69.2%、82.7%、46.7%。与对照组比较,非AMI组和AMI组患者血清H-FABP、cTnI水平显著升高,且AMI组显著高于非AMI组(P均<0.001)。AMI患者中重度组血清H-FABP[(9.15±1.39)μg/L比(7.63±1.25)μg/L]、cTnI[(0.72±0.13)ng/ml比(0.41±0.08)ng/ml]水平显著高于轻度组(P均<0.001)。ROC曲线分析显示:H-FABP、cTnI单独检测诊断AMI的最佳截断值分别为7.850μg/L,0.35ng/ml,心电图(AUC=0.680,95%CI 0.589~0.762)、H-FABP(AUC=0.781,95%CI 0.696~0.851)、cTnI(AUC=0.912,95%CI 0.847~0.956)联合检测对AMI的诊断价值(AUC=0.966,95%CI 0.916~0.991)要显著高于单独诊断(Z=6.783、4.499、2.954,P均<0.01)。结论:血清H-FABP、cTnI与AMI患者的冠脉病变程度有关,且血清H-FABP、cTnI联合心电图检查对AMI的诊断价值较高。Objective:To investigate diagnostic value of serum heart type fatty acid-binding protein(H-FABP),cardiac troponin I(cTnI)and electrocardiogram(ECG)for acute myocardial infarction(AMI).Methods:A total of 120 patients with chest pain suspected of AMI admitted in Hefei Eighth People's Hospital between March 2018 and March 2020 were enrolled.All patients received ECG and coronary angiography(CAG)examination.According to diagnostic criteria,they were divided into AMI group(n=75)and non-AMI group(n=45);according to Gensini score,AMI patients were divided into mild group(n=34),medium-severe group(n=41);another 120 healthy subjects undergoing physical examination simultaneously were treated as control group.Serum H-FABP and cTnI levels were measured in all groups.Receiver operating characteristic(ROC)curve was drawn to assess diagnostic value of H-FABP,cTnI and ECG and their combination for AMI.Results:With CAG as the gold standard,ECG examination showed that 62 cases were finally diagnosed among the 120 patients with chest pain suspected of AMI,the accuracy,sensitivity and specificity was 69.2%,82.7%,46.7%respectively.Compared with participants in control group,those in non-AMI group and AMI group had significant higher serum H-FABP and cTnI levels,and those of AMI group were significantly higher than those of non-AMI group(P<0.001 all).Serum levels of in medium-severe group H-FABP[(9.15±1.39)μg/L vs.(7.63±1.25)μg/L]and cTnI[(0.72±0.13)ng/ml vs.(0.41±0.08)ng/ml]were significantly higher than those of mild group(P<0.001 all).ROC curve analysis indicated that cut-off point of H-FABP and cTnI diagnosing AMI was 7.850μg/L,0.35ng/ml respectively,combined detection of ECG(AUC=0.680,95%CI 0.589~0.762),H-FABP(AUC=0.781,95%CI 0.696~0.851)and cTnI(AUC=0.912,95%CI 0.847~0.956)had significant higher diagnostic value(AUC=0.966,95%CI 0.916~0.991)than single diagnosis(Z=6.783,4.499,2.954,P<0.01 all).Conclusion:Serum H-FABP and cTnI were associated with the degree of coronary lesions in AMI patients,and the combination of serum

关 键 词：心肌梗死 脂肪酸结合蛋白类 肌钙蛋白I 心电描记术 

分 类 号：R542.22[医药卫生—心血管疾病]