心肌型脂肪酸结合蛋白（H—FABP）在诊断早期AMI中的临床应用

The use of human heart-type fatty acid-binding protein as an early diagnostic biochemical marker of acute myocardial infarction

目的探讨血清心肌型脂肪酸结合蛋白（H—FABP）在早期急性心肌梗死（AMI）诊断中的价值。方法选择疑似急性冠脉综合征患者102例，采用酶联免疫吸附法（Elisa）测定AMI发病3h内，4～6h、7～12h时血清中H—FABP浓度，并与心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK—MB）的检测结果进行比较，分析三种心肌损伤标志物在诊断不同发病时间段AMI的敏感性和特异性。结果在AMI发病3h内，H—FABP的诊断敏感性（66．7％）优于cTnI和CK—MB（P〈0．05）；在发病4～6h内，H—FABP的敏感性（94．4％）高于cTnI（61．1％）和CK—MB（50．0％），差异有统计学意义（P〈0．05）。结论在AMI发病6h内，H—FABP是最敏感的心脏标志物，尤以发病3h内敏感。

Objective To determine the early diagnostic value of H-FABP in acute myocardial infarction （AMI）. Methods The study consisted of 102 consecutive patients with the diagnosis of suspected acute coronary syndrome. The patients were then divided into groups of acute myocardial infarction （AMI）, unstable angina pectoris and non-acute coronary syndrome. The blood samples for H-FABP, cTnI, and CK-MB were obtained at admittance, within 3 h and 4-6 h,7-12 h after the onset of symptom. The sensitivity and specificity in diagnosis of early AMI were analyzed between H-FABP and cTnI and CK- MB. Results The overall sensitivities of H-FABP, cTnI and CK-MB, were 66.7%, 0, and 0% respectively for AMI patients presented within 3 h of onset of symptom. The sensitivity of H-FABP was significantly higher than cTnI and CK-MB （P〈0.05）. Sensitivity of H-FABP, cTnI and CK-MB within the 4-6 h of were 94.4%, 61.1%,and 50.0% respectively （P〈0.05）. Conclusion H-FABP is more sensitive in diagnosing AMI in the early phase within the 6 h as an early diagnostic cardiac marker of myocardial necrosis than cTn I and CK-MB.