联合检测心型脂肪酸结合蛋白和缺血修饰蛋白对急性非ST段抬高型心肌梗死患者的早期诊断意义

Significance of early diagnosis of acute non-ST segment elevation myocar-dial infarction with the combined testing of heart-type fatty acid binding protein and ischemia modified protein

目的探讨联合检测心型脂肪酸结合蛋白（H-FABP）和缺血修饰蛋白（IMA）对急性非ST段抬高型心肌梗死（NSTEMI）患者的早期诊断意义。方法选取2014年1月~2015年6月经急诊在我院心血管内科住院的71例急性胸痛患者,其发病时间均〈3 h、心电图未见ST段抬高,于胸痛发作3、6、12 h采血检测H-FABP、IMA、肌钙蛋白T（c Tn T）。根据最终诊断,非心源性胸痛患者共18例,设为对照组,NSTEMI共53例,设为NSTEMI组。结果与对照组比较,胸痛3 h时,NSTEMI组患者H-FABP、IMA升高,差异有统计学意义（P〈0.01）;胸痛6 h时,NSTEMI组患者H-FABP、IMA、c Tn T均显著升高,差异有统计学意义（P〈0.01）;胸痛3 h时,H-FABP、IMA诊断NSTEMI的敏感度均高于c Tn T（P〈0.01）,两者联合监测的敏感度更高（P〈0.05）。结论 H-FABP联合IMA检测可提高c Tn T未升高的NSTEMI患者的早期诊断效率。

Objective To explore the significance of early diagnosis of acute non-ST segment elevation myocardial infarction（NSTEMI） with the combined testing of heart-type fatty acid binding protein（H-FABP） and ischemia modified albumin（IMA）. Methods 71 patients with acute chest pain who were transferred from emergency department and hospitalized in the department of cardiovascular medicine in our hospital from January 2014 to June 2015 were selected.The onset time was all lower than 3 h,and ST-segment elevation was not detected in ECG.The blood was collected at 3,6,12 h after the onset of chest pain to test H-FABP,IMA and c Tn T.According to the final diagnosis,there were 18 patients with non-cardiac chest pain,who were assigned to the control group.There were 53 patients with NSTEMI,who were assigned to the NSTEMI group. Results Compared to the control group,at 3 h after chest pain,H-FABP and IMA in the NSTEMI group was increased respectively,and the differences was statistically significant（P 〈0.01）.At 6 h after chest pain,H-FABP,IMA and c Tn T was significantly increased respectively in the NSTEMI group,and the differences was statistically significant（P〈0.01）.At 3 h after chest pain,the sensitivity of H-FABP and IMA in the diagnosis of NSTEMI was higher than that of c Tn T respectively（P〈0.01）.The sensitivity of combined monitoring was higher（P 〈0.05）. Conclusion H-FABP combined with IMA testing may improve the early diagnosis efficiency of patients with NSTEMI whose c Tn T is not elevated.