急性高血压脑出血患者血清h-FABP水平变化及其临床应用价值

Changes and clinical value of heart-type fatty acid binding protein in patients with acute hypertensive cerebral hemorrhage

目的通过观察急性高血压脑出血患者血清心脏型脂肪酸结合蛋白(h-FABP)水平变化,探讨其临床检测价值。方法血清h-FABP采用双抗体夹心酶联免疫一步法定量检测;cTnI采用固相酶联免疫吸附实验(ELISA);CK-MB采用免疫抑制法测定HT5"H〗结果急性高血压脑出血患者组血清h-FABP水平显著高于对照组(P<0.01),大量出血者及意识不清者血清h-FABP水平分别显著高于小量出血者及意识清醒者(P<0.01);血清h-FABP阳性率显著高于血清cTnI、CK-MB及心电图的阳性率(P<0.01);死亡率为25.5%(28/110),血清h-FABP、cTnI、CK-MB及心电图异常组的死亡率显著高于正常组(P<0.01);血清h-FABP预测发生死亡具有高的敏感性和阴性预测值,特异性和准确度较低,但心电图具有较高的特异性(64.5%)和准确度(69.1%)。结论血清h-FABP定量测定可作为判断急性高血压脑出血病情轻重及评价发生意外的1项客观指标,联合心电图监测临床价值更高。

Objective To understand the clinical value of heart-type fatty acid binding protein （h-FABP） in patients with acute hypertensive cerebral hemorrhage（AHCE） through the variation analysis of its serum level.Methods Serum level of h-FABP was determined by enzyme-linked immunosorbent one-step quantitative detection,cardiac troponin I（cTnI） was detected by solid-phase enzyme-linked immunosorbent assay （ELISA） and isoenzyme MB of creatine kinase（CK-MB） was assayed by immunosuppression assay.Results The h-FABP level in（AHCE） group was significantly higher than healthy control group（P0.01） and that in AHCE patients with massive haemorrhage and unconsciousness was significantly higher than in patients with small heamorrhage and consciousness.The positive rate of h-FABP was significantly higher than cTnI,CK-MB and electrocardiogram（P0.01）.The mortality rate in patients,with abnormality of serum level of h-FABP,cTnI and CK-MB and ECG,was higher than patients without the abnormality,mentioned above （P0.01）.The sensitivity and negative predictive value of serum h-FABP for the prediction of fatality were high,but with low specificity and accuracy,although the specificity and accuracy of ECG were relatively higher,with 64.5% and 69.1% respectively.Conclusion Quantitative detection of serum h-FABP could be an objective indicator for the judgement of disease condition and the evaluation of accidental risk of AHCE,with more clinical application value,when being combined with ECG inspect.