缺血修饰清蛋白和心型脂肪酸结合蛋白检测在不稳定性心绞痛诊断及危险分层中的应用

Application of ischemia modified albumin and heart-type fatty acid-binding protein for the diagnosis and risk stratification of unstable angina

目的探讨血清缺血修饰清蛋白(IMA)、心型脂肪酸结合蛋白(H-FABP)、B型利钠肽(BNP)、同型半胱氨酸(Hcy)与不稳定性心绞痛(UA)危险分层的关联性,为临床提供评估患者病情的依据。方法选取135例不稳定性心绞痛(UA)患者作为病例组,根据全球急性冠状动脉事件注册(GRACE)危险评分软件,将病例组分为低危组70例、中危组60例及高危组5例;另选取体检健康者145例作为对照组。检测血清IMA、H-FABP、BNP及Hcy水平,将病例组与对照组、病例组各危险分层进行比较。结果将病例组与对照组比较,血清H-FABP、BNP及Hcy水平差异具有统计学意义(P<0.05),血清IMA差异无统计学意义(P>0.05);病例组内各危险分层IMA、H-FABP、Hcy水平差异均无统计学意义(P>0.05);高危组BNP水平高于低危组和中危组,差异有统计学意义(P<0.05),中危组与低危组比较差异无统计学意义(P>0.05)。结论 H-FABP、BNP及Hcy对临床诊断UA有一定意义,BNP对患者病情危险程度有提示作用。

Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine was found （P〈0.05）,but the difference of ischemia modified albumin was not statistically significant（P〉0.05）.In the disease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference（P〉0.05）.The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant （P〈0.05）,while there was no statistically significant difference between the low-risk group and the middle-risk group（P〉0.05 ）.Conclusion The detection of hearttype fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angina,and the level of B-type natriuretic peptide indicates the risk degree of the disease.