心脏脂肪酸结合蛋白在早期急性心肌梗死诊断中的价值

The value of heart-type fatty acid binding protein in the early diagnosis of acute myocardial infarction

目的:探讨心脏型脂肪酸结合蛋白(H-FABP)在急性心肌梗死(AMI)诊断中的价值。方法:选取2016年5月至2017年8月,因急性胸痛就诊的患者187例,其中确诊为AMI患者83例(AMI组),非AMI患者104例(非AMI组),入院即刻采血测定心肌肌钙蛋白(cTnI)、肌酸激酶同工酶(CKMB)及H-FABP水平。结果:AMI组患者cTnI、CK-MB水平及H-FABP阳性率分别为5.64(0.43,12.66)μg/L、7.22(5.01,16.55)μg/L和84.34%,明显高于非AMI组(P<0.05);H-FABP诊断AMI的灵敏度为84.3%,明显高于cTnI和CK-MB(P<0.05),而特异度为79.81%,明显低于cTnI和CK-MB(P<0.05);胸痛发作到检测时间<6h时,H-FABP诊断AMI的灵敏度为93.33%,明显高于cTnI和CK-MB(P<0.05),特异为83.61%,明显低于CK-MB(P<0.05),而与cTnI比较,差异无统计学意义(P>0.05)。结论:相对于cTnI和CK-MB,H-FABP在早期诊断AMI中有较好的诊断价值,尤其对于胸痛发作到检测时间<6h内的患者,其诊断价值较高。

Objective： To investigate the value of heart-type fatty acid binding protein（ H-FABP） in the diagnosis of acute myocardial infarction（ AMI）. Methods： From May 2016 to August 2017,187 patients with acute chest pain were selected,of whom 83 patients were diagnosed with AMI（ AMI group）,and 104 patients with non AMI（ non AMI group）,immediately after admission blood samples were taken to determine the levels of cTnI,CK-MB and H-FABP. Results： The cTnI,CK-MB levels and H-FABP positive rates in AMI group were 5. 64（ 0. 43,12. 66） μg/L,7. 22（ 5. 01,16. 55） μg/L and 84. 34%,respectively,which were significantly higher than those in the non AMI group（ P〈0. 05）; The sensitivity of H-FABP diagnosis of AMI was84. 34%,higher than that of cTnI and CK-MB（ P〈0. 05）,and the specificity was 79. 81%,which was significantly lower than that of cTnI and CK-MB（ P〈0. 05）; The onset of chest pain to the detection time 6 h,the sensitivity of H-FABP diagnosis of AMI was 93. 33%,significantly higher than that of cTnI and CK-MB（ P〈0. 05）,specificity was 83. 61%,significantly lower than CK-MB（ P〈0. 05）,but no significant difference compared with cTnI（ P〉0. 05）. Conclusion： Compare with cTnI and CK-MB,H-FABP has better diagnostic value in the early diagnosis of AMI,especially in the onset of chest pain to the detection time 6 h,its diagnostic value is higher.