心型脂肪酸结合蛋白与超敏肌钙蛋白Ⅰ联合检测在急性心肌梗死早期诊断中的价值  

Diagnostic Value of Combined h-FABP and hs-cTnⅠin Early Detection of Acute Myocardial Infarction

作　　者：刘阳 吴翠翠[1] 杨春雪 李彬先[1] 刘丽[1] LIU Yang;WU Cuicui;YANG Chunxue;LI Binxian;LIU Li(Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报(自然科学版)》2025年第3期350-354,共5页Journal of Beihua University(Natural Science)

基　　金：吉林省教育厅科学技术研究项目(JJKH20240100KJ);吉林省卫生健康科技能力提升项目(2023LC023);吉林市医疗卫生指导性计划项目(20220404033)。

摘　　要：目的探讨联合检测心型脂肪酸结合蛋白(heart-type fatty acid binding protein,h-FABP)和超敏肌钙蛋白Ⅰ(high-sensitivity cardiac troponinⅠ,hs-cTnⅠ)在急性心肌梗死(acute myocardial infarction,AMI)6 h内的早期诊断价值。方法将300例患者根据临床诊断分为急性心肌梗死组(AMI)、陈旧性心肌梗死组(OMI)和心绞痛组(AP),另外设立健康对照组,运用计算软件计算截断值和约登指数,比较两个指标单独检测和联合检测在健康人群和危险人群中的灵敏度、特异度,采用受试者工作特征(ROC)曲线分析评价h-FABP和hs-cTnⅠ联合检测对急性心肌梗死的早期诊断价值。结果h-FABP的截断值和约登指数分别是7.030和0.624。所有人群中,两个指标联合检测的灵敏度和特异度分别为0.704和0.778,AUC面积为0.823;正常人群中,h-FABP和hs-cTnⅠ联合检测的灵敏度和特异度分别为0.776和0.980,AUC面积为0.933;可疑人群中,两项指标联合检测结果均大于任意指标单独检测(P<0.05)。结论h-FABP、hs-cTnⅠ联合检测有助于提高AMI早期诊断的灵敏度和特异度,降低漏诊率和误诊率,提高临床诊断效用。Objective To investigate the value of combined detection of heart-type fatty acid binding protein(h-FABP)and high-sensitivity cardiac troponinⅠ(hs-cTnⅠ)for early diagnosis within 6 hours of acute myocardial infarction(AMI).Methods Three hundred patients were divided into acute myocardial infarction(AMI),old myocardial infarction(OMI),and angina pectoris(AP)based on clinical diagnosis.In addition,a healthy control group was established.Calculation software was used to determine the cutoff value and Youden’s index.The sensitivity and specificity of detecting the two indicators alone and in combination were compared in healthy and high-risk populations.The value of combined detection of h-FABP and hs-cTnⅠfor the early diagnosis of acute myocardial infarction was evaluated by using Receiver Operating Characteristic(ROC)curve analysis.Results The cutoff value and Youden’s index of h-FABP were 7.030 and 0.624,respectively.The sensitivity and specificity of the combined detection of two indicators in all populations were 0.704 and 0.778,respectively,AUC=0.823.The sensitivity and specificity of the combined detection of h-FABP and hs-cTnⅠin normal population were 0.776 and 0.980,respectively,AUC=0.933.The results of the joint detection of two indicators insuspicious population were also greater than those of any indicator detected separately(P<0.05).Conclusion The combined detection of h-FABP and hs-cTnⅠindicators can enhance the sensitivity and specificity of early diagnosis of AMI.This approach helps reduce the rates of missed diagnoses and misdiagnoses,thereby improving clinical diagnostic utility.

关 键 词：心型脂肪酸结合蛋白 超敏肌钙蛋白Ⅰ 急性心肌梗死 陈旧性心肌梗死 

分 类 号：R542.2[医药卫生—心血管疾病]