心脏型脂肪酸结合蛋白在急性心肌梗死早期诊断中的临床意义

Clinical significance of heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction

目的通过连续测定急性心肌梗死（AMI）患者血浆心脏型脂肪酸结合蛋白（H—FABP）水平，探讨其在AMI早期诊断中的意义。方法采用固相夹心酶联免疫法测定46例AMI患者在发病后30min,1h、2h、4h、6h及12h血浆H—FABP水平，同时测定心肌肌钙蛋白I（cTnI）和肌酸激酶同工酶MB（CK-MB）水平，比较三种心肌损伤标志物诊断AMI的准确率。结果AMI发病时间≤6h，H-FABP诊断AMI的准确率[95．7％（44／46）]明显高于cTnI[65．2％（30／46）]和CK．MB[41．3％（19／46）]，差异有统计学意义（P〈0．05）。H-FABP在AMI发病后4h即显著升高，cTnI在AMI发病后6h显著升高，CK．MB在AMI发病后12h显著升高。结论H．FABP在AMI诊断中具有较高的准确率，可作为AMI早期诊断的指标。

Objective To explore the clinical significance of heart-type fatty acid-binding protein （H-FABP） in acute myocardial infarction （AMI） patients. Methods The level of H-FABP was assayed within 30 rain, 1 h, 2 h, 4 h,6 h and 12 h by enzyme linked immunosorbent assay （ELISA） in 46 AMI patients, and cardiac troponin I （cTnI） and creatinine kinase （CK-MB） also was assayed by routine method. The diagnostic accuracy was compared among different methods. Results The diagnostic accuracy of H-FABP[95.7% （44/46） ] was significantly higher than cTni[65.2%（30/46） ] and CK-MB[41.3% （ 19/46）] （P 〈 0.05）. The levels of H-FABP, cTnI and CK-MB significantly increased after AMI onset 4,6,12 h respectively. Conclusion The diagnostic accuracy of H-FABP is higher and can he used as a parameter for the early diagnosis of AMI.