探讨慢性心衰患者联合检测肌红蛋白和心型脂肪酸结合蛋白的临床价值

To explore the clinical significance of the Chronic Heart Failure diagnosis by the Myoglobin and the Heart-type Fatty Acid-Binding Protein combined testing

目的探讨慢性心衰患者联合检测肌红蛋白和心型脂肪酸结合蛋白的临床价值,结合临床表现为临床诊治提供依据。方法选择确诊为慢性心衰者共78例,设为研究组,另外配对选择可比性强的同期体检健康者的80例设为对照组,均检测心型脂肪酸结合蛋白和肌红蛋白浓度水平,综合分析结果。结果研究组患者的肌红蛋白和心型脂肪酸结合蛋白浓度水平检测结果均明显高于对照组,差异具有统计学意义(P<0.05);阳性检出率分析可见,研究组患者单独检测肌红蛋白和心型脂肪酸结合蛋白的阳性检出率分别为87.18%和88.46%,均明显低于两项指标联合检测阳性检出率(94.87%),差异均有统计学意义(P<0.05);对检测结果临床符合性进行分析,以临床确诊结果为金标准,采用Kappa一致性检验分析检测结果和临床确诊结果的符合性,得出联合两项指标检测的Kappa值为0.95,单独检测肌红蛋白的Kappa值为0.87,单独检测心型脂肪酸结合蛋白的Kappa值为0.89。结论肌红蛋白和心型脂肪酸结合蛋白都是辅助检测慢性心衰疾病的良好指标,具有较高的灵敏度和临床符合性,联合检测可以有效降低漏诊率和误诊率,值得推广。

Objective To explore the clinical significance of the Chronic Heart Failure diagnosis by the Myoglobin and the Heart-type Fatty Acid-Binding Protein combined testing,providing the basis for clinical diagnosis and treatment.Methods Choosing 78 cases of patients with Chronic Heart Failure for the study group and 80 cases healthy check-up for the control group,testing the Myoglobin and the Heart-type Fatty Acid-Binding Protein,analyze the results comprehensively.Results There were significantly higher of the study group of the Myoglobin and the Heart-type Fatty Acid-Binding Protein results（P〈0.05）.The positive detection rate of the Myoglobin and the Heart-type Fatty Acid-Binding Protein was 87.18%and 88.46%,and they were all lower than the positive detection rate of the two indicators combined testing（94.87%）（P〈0.05）.With clinical diagnosis as the gold standard,the Kappa of the combined testing was 0.95,the Kappa of the Myoglobin testing was 0.87,the Kappa of the Heart-type Fatty Acid-Binding Protein testing was 0.89.Conclusion There are all good indicators of the Myoglobin and the Heart-type Fatty Acid-Binding Protein for the Chronic Heart Failure diagnosis which have good sensitivity,and we can use them for the screening which can effectively improve reduce the rate of misdiagnosis by they combined testing.