心脏型脂肪酸结合蛋白在诊断早期急性非ST段抬高心肌梗死中的临床应用

Clinical application of H-FABP in diagnosis of early stage Non-ST elevated myocardial infarction （NSTEMI）

目的探讨心脏型脂肪酸结合蛋白（H—FABP）在临床诊断早期急性非sT段抬高心肌梗死（NSTEMI）中的优势及应用价值。方法疑似NSTEMI患者118例，按发病后就诊时间分为两组，分别在发病后0-3h、3-6h内检测H—FABP，同时检测肌钙蛋白I（cTnI）、肌酸激酶同功酶（CK—MB）及肌红蛋白（MYO）进行对比，计算各项指标的灵敏度、特异性、准确性、阳性预测值及阴性预测值并进行比较分析。结果H—FABP在发病0-3h内诊断NSTEMI的灵敏度为66．7％，高于cTnI及CK—MB，差异有统计学意义（P〈0．05）；特异性为88．9％；准确性为78．4％。在发病3-6h内诊断NSTEMI的灵敏度为94．4％，高于cTnI及cK—MB，差异有统计学意3L（P〈0．05），特异性87．1％，准确性为91．0％。结论H—FABP是诊断早期（发病6h以内）NSTEMI的敏感指标，在急性冠脉综合征早期的危险分层中有重要的临床应用价值。

Objective To study and master the advantage and its applicable value of Heart-type fatty acid-binding protein （H-FABP） in diagnosing the early stage Non-ST elevated myocardial infarction （NSTEMI）. Methods H-FABP, cTnl, CK-MB and myoglobin were detected synchronously within 3 hours and 6 hours at 118 cases of suspected NSTEAMI. The data of sensitivity, specificity, accuracy, positive predictive value and negative predictive value was obtained and calculated. Results The sensitivity of H-FABP within 3 hours was 66.7%, higher than that of cTnI and CK-MB （P〈0. 05）; the specificity was 88.9%, and the accuracy was 78.4%. The sensitivity of H-FABP within 3 hours was 94.4%, also higher than that of cTnI and CK-MB （P〈0.05）; the specificity was 87.1%, and the accuracy was 91.0%. Conclusion H-FABP, the most sensitive indicator of early NSTEAMI （within 6 hours） diagnosis, reflected critical clinical value for the risk stratification of acute coronary syndrome.