HAFBP对急性心肌梗死早期的诊断价值

Diagnostic value of HAFBP for early acute myocardial infarction

目的:研究心肌型脂肪酸结合蛋白(HAFBP)对急性心肌梗死(AMI)早期的诊断价值。方法:依据诊断结果,于我院治疗的胸痛或者胸部不适的125例患者被分为AMI组(65例)与非AMI组(60例)。比较两组发病4h和8h时血清心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)、HAFBP水平,分析比较上述指标对AMI的诊断价值。结果:与非AMI组比较,AMI组发病4h、8h血清cTnI[4h:(3.43±0.70)μg/L比(4.70±0.95)μg/L,8h:(4.25±1.05)μg/L比(5.43±1.11)μg/L]、CK-MB[4h:(2.19±0.35)μg/L比(5.93±0.61)μg/L,8h:(2.59±0.33)μg/L比(7.48±0.58)μg/L]、HAFBP水平[4h:(12.66±2.10)μg/L比(27.34±7.50)μg/L,8h:(12.94±3.03)μg/L比(33.61±9.18)μg/L]升高更显著(P均=0.001)。cTnI、CK-MB、HAFBP发病4h后诊断AMI的敏感度分别为61.54%、63.08%及84.62%,特异度分别为88.33%、90.00%及78.33%,准确度分别为74.40%、76.00%及81.60%;HAFBP诊断AMI的灵敏度显著高于cTnI与CK-MB(P均<0.01);发病8h后三种指标诊断AMI的敏感度、特异度和准确度均无显著差异(P均>0.05)。结论:HAFBP对AMI有较高的诊断价值,值得推广。

Objective:To study diagnostic value of heart type fatty acid-binding protein(HAFBP)for early acute myocardial infarction(AMI).Methods:According to diagnostic results,a total of 125 patients with chest pain or chest discomfort treated in our hospital were divided into AMI group(n=65)and non-AMI group(n=60).Serum levels of cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB)and HAFBP were compared between two groups 4h and 8h after onset.Diagnostic value of above indexes for AMI were analyzed.Results:Compared with non-AMI group on 4h and 8h after onset,there were significant rise in serum levels of cTnI[4h:(3.43±0.70)μg/L vs.(4.70±0.95)μg/L,8h:(4.25±1.05)μg/L vs.(5.43±1.11)μg/L],CK-MB[4h:(2.19±0.35)μg/L vs.(5.93±0.61)μg/L,8h:(2.59±0.33)μg/L vs.(7.48±0.58)μg/L]and HAFBP[4h:(12.66±2.10)μg/L vs.(27.34±7.50)μg/L,8h:(12.94±3.03)μg/L vs.(33.61±9.18)μg/L]in AMI group(P=0.001 all).Sensitivity of cTnI,CK-MB and HAFBP in diagnosing AMI 4h after onset was 61.54%,63.08%and 84.62%respectively,specificity was 88.33%,90.00%,and 78.33%respectively,and accuracy was 74.40%,76.00%,and 81.60%respectively.Sensitivity of HAFBP in diagnosing AMI 4h after onset was significantly higher than those of cTnI and CK-MB(P<0.01 all).There were no significant difference in sensitivity,specificity and accuracy of cTnI,CK-MB and HAFBP in diagnosing AMI 8h after onset,P>0.05 all.Conclusion:HAFBP possesses high diagnostic value for AMI,which is worth extending.