H-FABP在急性心肌梗死早期诊断中的临床应用价值分析

Clinical application value of H-FABP in the early diagnosis of acute myocardial infarction

目的：探讨血清心肌型脂肪酸结合蛋白（H-FABP）在急性心肌梗死（AMI）患者早期诊断中的临床应用效果。方法：选取疑似急性冠脉综合征（ACS）患者98例及健康人群（健康组）30例,分别采集两组患者发病1~3h、4~8h、9~15h内的静脉血,检测血清H-FABP、肌酸激酶同工酶（CK-MB）、肌钙蛋白（CTnI）、肌红蛋白（MYO）,并进行组内比较;以最终临床诊断结果作为金标准,计算四种血清心肌标志物早期诊断AMI的诊断学评价指标。结果：在发病1~3h时间段,AMI组患者H-FABP、MYO指标检出水平均显著的高于健康组、UAP组、非ACS组,差异均具有统计学意义;而CK-MB、CTnI检出水平与健康组、UAP组、非ACS组患者比较,差异无统计学意义;AMI组H-FABP、MYO、CK-MB、CTnI检出水平在发病4~8h时间段均显著的高于健康组、UAP组、非ACS组差异均具有统计学意义;在发病9~15h时间段CK-MB、CTnI达到更高水平并且显著的高于健康组、UAP组、非ACS组患者,差异均具有统计学意义。H-FABP早期诊断结果与最终临床诊断比较,正确诊断AMI患者41例、非AMI患者46例,诊断结果与临床最终确诊结果的一致率Kappa=0.775;CK-MB早期诊断AMI患者的一致率Kappa=0.357;CTnI早期诊断AMI患者的一致率Kappa=0.171;MYO早期诊断AMI患者的一致率Kappa=0.487。结论：H-FABP在急性心肌梗死早期即出现水平显著的升高,并且诊断结果与最终临床诊断具有较高的一致性。

Objective：To study the serum myocardial fatty acid binding protein（H-FABP）in early diagnosis of patients with acute myocardial infarction（AMI）clinical application effect,and to explore the sensitive indexes of early diagnosis of AMI.Methods：Choose 98 cases of patients with suspected acute coronary syndrome（ACS）and 30 cases of healthy people（healthy group）were collected in patients with onset of 1~3h,4~8h,9~15hin venous blood,serum was detected in H-FABP,creatine kinase isoenzyme（CK-MB）,troponin（CTnI）,myoglobin（MYO）and compare within the group,in the final clinical diagnosis as the gold standard,calculation of the four kinds of serum cardiac markers for early diagnosis of AMI diagnostic evaluation index.Results：The first time 1~3h,AMI group of patients with H-FABP,MYO index check out of the water,on average,significantly higher than healthy group,the patients with UAP group,the ACS group the differences were statistically significant;and CK-MB,CTnI the detection of the health group,UAP group,the non-ACS patients,the difference was not statistically significant;AMI group H-FABP,MYO,CK-MB,CTnI detectable levels in the incidence was significantly higher than the 4~8hperiod healthy group,UAP group,the non-ACS group differences were statistically significant;in the pathogenesis of 9~15hperiod CK-MB,CTnI to a higher level and significantly higher than the healthy group,UAP group,the non-ACS patients,the differences were statistically significant.H-FABP early diagnosis and compare the final clinical diagnosis,the correct diagnosis of AMI in 41 patients,46patients with non-AMI,consistent rate of clinical diagnosis and the final diagnosis result Kappa=0.775;CK-MB early diagnosis of AMI patient concordance rates Kappa=0.357;consistent rate CTnI early diagnosis of AMI in patients with Kappa=0.171;consistent rate MYO early diagnosis of AMI in patients with Kappa=0.487.Conclusion：H-FABP in early acute myocardial infarction appears significantly elevated levels,and the final diagnosis and clinical diagnosis of high consistency..