心肌型脂肪酸结合蛋白和肌钙蛋白T联合检测对诊断急性冠脉综合征的意义

The significance of heart fatty acid-binding protein and cardiac troponin T in early diagnosis of acute coronary syndromes

目的探讨血清心肌型脂肪酸结合蛋白(H-FABP)和肌钙蛋白T(cTnT)联合检测对诊断急性冠脉综合征(ACS)的意义。方法选择80例ACS患者,其中不稳定型心绞痛组35例,心肌梗死组45例。分别于胸痛发作2、3、6、12、24h采静脉血检测其H-FABP和cTnT的水平,与对照组比较。结果在不稳定心绞痛或心肌梗死发病6h以内,患者H-FABP显著升高(P<0.05),而12h以后的改变不明显。不稳定型心绞痛在发病24h以内,cTnT的改变并无显著意义,但心肌梗死患者的cTnT在24h内则显著升高(P<0.05)。结论联合检测H-FABP和cTnT水平对于ACS的早期诊断和不稳定心绞痛与心肌梗死的鉴别诊断具有实用价值。

Objective To discuss the significance of heart fatty acid-binding protein（H-FABP） and cardiac troponin T（cTnT） in early diagnosis of acute coronary syndromes（ACS）. Methods 80 patients with ACS were ehrolled and divided into group A（35 pa- tients with unstable angina） and group B（45 patients with acute myocardial infarction） ,and concentrations of H FABP and cTnT in blood were determined respectively at 2,3,6,12 and 24 h after chest pain onset. Results H-FABP increased significantly in both groups within 6 h after chest painonset, but did not significantly change from 12 to 24 h. Concentration of cTnT remained unaltered in group A within 24 h, but increased significantly in group 13. Conclusion The determination of serum levels of H-FABP and cTnT had practical value of distinguishing acute myocardial infarction patients from unstable angina among ACS in early diagnosis.