联合检测心肌损伤标志物在急性冠脉综合征早期诊断的意义

Significance of Combined Detection of Myocardial Injury Markers in the Early Diagnosis of Acute Coronary Syndrome

目的探讨心脏型脂肪酸结合蛋白(H-FABP)、缺血修饰白蛋白(IMA)联合检测在急性冠脉综合征(ACS)早期诊断和危险分层中的临床意义。方法选取我院2015年1月至2017年8月收治的300例ACS患者,根据其疾病类型分为UA组和AMI组各150例,根据GRACE危险评分又将300例ACS患者分为低危组(65例)、中危组(120例)、高危组(115例)。另选取同期我院150名体检健康者作为对照组。观察不同疾病患者的阳性率以及不同疾病危险程度患者的血清H-FABP、IMA表达水平。结果 UA组与AMI组的H-FABP、IMA、cTnI、CK-MB阳性率均明显高于对照组,AMI组的H-FABP、cTnI、CKMB阳性率均明显高于UA组,且UA组与AMI组的H-FABP、IMA阳性率均高于cTnI、CK-MB阳性率(P均<0.05)。HFABP、IMA联合检测的灵敏度与特异度最高(P<0.05)。结论 H-FABP、IMA联合检测在ACS中具有较高的诊断价值,可准确检测出疾病类型,有助于判断疾病危险程度,为临床尽早实施救治提供可靠依据。

Objective To explore the clinical significance of heart-type fatty acid binding protein （H-FABP） and ischemic modified albumin （IMA） combined detection in the early diagnosis and risk stratification of acute coronary syndrome （ACS）. Methods 300 cases of ACS patients admitted to our hospital from January 2015 to August 2017 were selected and divided into UA group and AMI group according to disease type, with 150 cases in each group. 300 cases of ACS patients were also divided into low risk group （65 cases）, medium risk group （120 cases） and high risk group （115 cases） according to GRACE risk score. At the same time, 150 healthy people with physical examination in our hospital were selected as the control group. The positive rate of patients with different diseases, and serum H-FABP and IMA expression levels of patients with different danger degrees were observed. Results The positive rates of H-FABP, IMA, cTnI and CK-MB of UA group and AMI group were significantly higher than those of control group （P 〈0.05）. The positive rates of H-FABP, cTnI and CK-MB of AMI group were significantly higher than those of UA group （P〈0.05）. The positive rates of H-FABP and IMA of UA group and AMI group were higher than those of cTnI and CK-MB （P 〈0.05）. H-FABP and IMA combined detection has highest sensitivity and specificity （P〈0.05）. Conclusions H-FABP and 1MA combined detection has higher diagnostic value in ACS, which can accurately detect the disease types, help determine the danger degree of disease, and provide reliable basis for clinical treatment as early as possible.