心脏型脂肪酸结合蛋白在非瓣膜型慢性心力衰竭中的价值

Value of H-FABP in patients with nonvalvular chronic heart failure

目的探讨非瓣膜型慢性心力衰竭患者血清心脏型脂肪酸结合蛋白(H-FABP)水平及临床意义。方法选择非瓣膜型不同心功能级别患者35例及健康体检者20例,测定血清H-FABP、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)浓度,同时观察住院期间及随访2个月心脏事件与非心脏事件发生情况H-FABP水平。结果H-FABP浓度在心功能Ⅱ级、Ⅲ级、Ⅳ级组分别是(4.30±1.28)、(6.06±1.03)、(7.64±1.56)ng/ml。两两比较,差异均有统计学意义(P<0.05)。与对照组比较,心功能Ⅱ级组差异无统计学意义(P>0.05),余差异均有统计学意义(P<0.05);CK浓度在心力衰竭各亚组及对照组间差异均无统计学意义(P>0.05);CK-MB浓度在心功能Ⅳ级组与其他心力衰竭亚组及对照组间差异均有统计学意义(P<0.05),余各组间比较差异均无统计学意义(P>0.05)。住院期间及随访2个月发生心脏事件的H-FABP浓度(7.95±1.30)ng/ml与非心脏事件的H-FABP浓度(5.02±1.31)ng/ml相比,差异有统计学意义(P<0.05)。结论H-FABP对判断非瓣膜型慢性心力衰竭患者心肌损伤程度及预后有重要临床价值。

Objective To discuss the level and clinical meaning of H-FABP in patients with nonvalvular chronic heart failure. Methods To select 35 patients with nonvalvular chronic heart failure who had varied classes of cardiac function and control group were 20, data Of H-FABP, CK, CK-MB were detected, and to observe H-FABP level in patients with cardiac events were compared to those without it duration of hospital stay and follow up 2 months. Results The serum level of H-FABP in patients with heart function Ⅱ, Ⅲ, Ⅳ were （4. 30 ± 1.28 ） ng/ml, （ 6. 06 ± 1.03 ） ng/ml, （ 7. 64 ± 1.56 ） ng/ml respectively. There is statistical difference intereomparsion（P 〈0. 05）. To compare with control group,there was no statistical difference in patients with heart function H （ P 〉 0. 05 ） , and there was statistical difference among patients with heart function m, Ⅳ （ P 〈 0. 05 ）. there was no statistical difference of the serum level of CK among each group intercomparsion （ P 〉 0. 05 ）. there was statistical difference of the serum level of CK-MB between patients with function Ⅳ and the others （P 〈0.05 ） , there was no statistical difference among other groups （P 〉 0. 05 ）. Duration of hospital stay and follow up 2 months, the serum level of H-FABP in patients with cardiac events was （7. 95 ± 1.30）ng/ml, and in patients without it was （ 5.02 ± 1.31 ） ng/ml, there was statistical difference （ P 〈 0. 05 ）. Conclusion H-FABP has more significant clinical value in judging myocardial degree of injury and prognosis of patients with nonvalvular chronic heart failure.