心型脂肪酸结合蛋白在急性心肌梗死早期诊断中的临床应用

The clinical application of heart-fatty acid binding protein in AMI early diagnosis

目的探讨心型脂肪酸结合蛋白(heart-fatty acid binding protein,H-FABP)对早期诊断急性心肌梗死(acute myocardial infarction,AMI)的临床应用价值。方法选取2013年1月至2015年6月我院诊断为AMI的患者151例为AMI组,同期选择有胸痛指征但最终排除AMI诊断的其他疾病患者68例为对照组,检测两组患者发病后0-3 h、3-6 h、6-12 h血清H-FABP、心肌肌钙蛋白I(cardiac troponin I,cTnI)、肌酸激酶(creatine kinase,CK)及肌酸激酶同工酶(MB isoenzyme of creatine kinase,CKMB)水平,对检测结果进行统计学分析。结果 AMI组0-3 h、3-6 h、6-12 h的H-FABP、cTnI、CK、CKMB检测水平均显著高于对照组,且差异均具有统计学意义(P均<0.05)。血清H-FABP诊断AMI的灵敏度、特异性及受试者工作特征曲线下面积分别为78.8%、89.7%及0.919,均高于其他三项指标。所有AMI患者中,H-FABP与cTnI、CK及CK-MB在不同时间段的检测结果均有较好的相关性,且相关系数r均>0.8。结论 H-FABP对早期诊断AMI有较好的临床应用价值,优于cTnI、CK及CK-MB。

Objective To investigate the clinical application value of heart-fatty acid binding protein（H-FABP） in acute myocardial infarction（AMI） diagnosis.Methods 151 cases AMI patients in our hospital from January 2013 to June 2015 were collected as the AMI group.68 cases patients with chest pain indications but obviated AMI during the same period were selected as the control group.The levels of H-FABP,cardiac troponin I（cTnI）,creatine kinase（CK） and MB isoenzyme of creatine kinase（CK-MB） at 0-3 h,3-6 h,6-12 h of all the patients to fall in disease were detected.The results were analyzed statistically.Results The levels of H-FABP,cTnI,CK and CK-MB at 0-3 h,3-6 h,6-12 h in AMI group were all higher than that of control group,and the differences all had statistical significance（Pall 〈0.05）.The sensitivity,specificity and area under receiver characteristic operating curve were 78.8%,89.7% and 0.919,respectively,which were all higher than that of the other three index.There were better correlation among H-FABP and cTnI,CK,CK-MB during each period,and the coefficient correlation r were all higher than 0.8.Conclusion The diagnosis value of H-FABP is better than that of cTnI,CK and CK-MB in AMI diagnosis.