心脏型脂肪酸结合蛋白在不稳定型心绞痛患者危险分层诊断中的价值

Diagnosis value of heart-type fatty acid-binding protein in risk stratification of patients with unstable angina pectoris

目的探讨不稳定型心绞痛(UAP)患者不同危险分层血清心脏型脂肪酸结合蛋白(H-FABP)的水平及临床意义。方法分别测定稳定型心绞痛(SAP)患者20例(SAP组)、UAP患者55例(UAP组)、健康体检者30例(对照组)的血清H-FABP水平,并根据危险分层将UAP组分为低危组、中危组、高危组三个亚组。结果对照组血清H-FABP水平为(4.24±1.40)ng/ml,SAP组为(4.46±1.30)ng/ml,UAP组为(6.05±1.57)ng/ml;UAP低危组、中危组、高危组分别为(4.82±1.18)、(5.96±1.01)、(7.51±1.11)ng/ml。UAP低危组、SAP组、对照组血清H-FABP水平两两比较均无统计学差异(P均>0.05);UAP组与对照组、SAP组比较均有统计学差异(P均<0.01);UAP低危组、中危组、高危组两两比较均有统计学差异(P均<0.01)。结论血清H-FABP水平随UAP危险程度增加而升高,可根据H-FABP水平对UAP患者进行危险分层。

Objective To determine the value of heart-type fatty acid-binding protein （H-FABP） in risk stratification of patients with unstable angina pectoris. Methods Serum H-FABP levels were measured in 105 subjects who were divided into three groups： stable angina pectoris group （SAP）, 20 patients; unstable angina pectoris group （UAP）, 55 patients; and normal control group, 30 subjects. Results Serum H-FABP levels of unstable angina pectoris, stable angina pectoris group and normal control group were （4.82 ± 1.18 ）, （4.46 ± 1.30 ） and （4. 24 ± 1.40 ） ng/ml respectively, and there were not statistically significant among those three groups. Serum H-FABP levels were significantly higher in unstable angina pectoris group than in normal control group [ （6.05 ± 1.57） ng/ml vs （4.24 ± 1.40） ng/ml, P 〈0.01 ]. According to the risk stratification of unstable angina pectoris patients, serum H-FABP levels in high-risk subgroup were the highest among low-risk, middle-risk and high-risk subgroup （ P 〈 0.01 ） ; serum H-FABP levels were significantly higher in middle-risk patients than in low-risk patients （ P 〈 0.01 ）. Conclusions Elevation of H-FABP is associated with an high-risk stratification of unstable angina pectoris patients. High serum H-FABP levels may represent latent cardiac injury.