心脏型脂肪酸结合蛋白对急性冠状动脉综合征早期诊断价值研究

Study on the value of heart-type fatty acid-binding protein in early diagnosis of acute coronary syndrome

目的探讨血清心脏型脂肪酸结合蛋白(H-FABP)及其与CK-MB、Mb、cTnI联合检测对急性冠状动脉综合征的早期诊断价值。方法采用免疫比浊法定量测定83例急性冠状动脉综合征(ACS)患者[40例急性心肌梗死(AMI)患者和43例不稳定心绞痛(UAP)患者]及40例健康体检者血清H-FABP浓度,同时测定CK-MB、Mb、cTnI浓度,并进行分析。结果 AMI组、UAP组患者血清H-FABP、CK-MB、Mb、cTnI浓度显著高于对照组(P<0.05)。ACS组患者H-FABP的ROC曲线下面积(AUC)高于CK-MB、Mb、cTnI(0.825、0.648、0.735、0.758);H-FABP的灵敏度、特异度、约登指数(Youden指数)、阳性预测值及阴性预测值均高于CK-MB、Mb、cTnI;H-FABP与Mb、cTnI联合检测的ROC曲线面积增大。结论血清H-FABP浓度与心肌缺血损伤有关,H-FABP与Mb、cTnI联合检测对ACS的早期诊断有重要临床价值。

[Objective] To study the value of serum heart-type fatty acid-binding protein （H-FABP） and the combined detection of H-FABP, CK-MB, Mb, cTnI in early diagnosis of acute coronary syndrome （ACS）. [Methods] Using immunoturbidimetry to detect the concentration of serum H-FABP in 83 patients with acute coronary syndrome （ACS） （40 cases of acute myocardial infarction （AMI） and 43 cases with unstable angina pectoris （UAP） and 40 cases of healthy people. The concentration of serum CK-MB, Mb, cTnl was detected synchronously and data were compared statistically. [Results] The concentration of serum H-FABP, CK-MB, Mb, cTnI in group AMI and group UAP were significantly higher than those in the control group （P 〈0.05）. The area under the ROC curve of H-FABP in ACS group is higher than that of CK-MB, Mb, cTnI （0.825, 0.648, 0.735, 0.758）. The sensitivity, specificity, Youden index, positive predictive value and negative predic- tive value of H-FABP were higher than those of CK-MB, Mb, cTnI. The area under ROC curve of combined detection of H-FABP, Mb, cTnI increased. [Conclusion] The concentration of serum H-FABP is closely re- lated to myocardial ischemial injury. Significantly clinical value may exist in the early diagnosis of ACS by combined detection of H-FABP and Mb, cTnI.