联合检测心脏型脂肪酸结合蛋白、心肌肌钙蛋白I及脑钠肽在急性心肌梗死早期诊断中的意义研究

The significance of combined detection of cardiac fatty acid binding protein troponin I brain natriuretic peptide in early diagnosis of acute myocardial infarction

目的分析联合检测心脏型脂肪酸结合蛋白(H-FABP)、心肌肌钙蛋白I(cTnI)、脑钠肽(BNP)在急性心肌梗死(AMI)早期诊断中的意义。方法选取232例急诊科患者为研究对象,其中128例AMI患者作为AMI组,104例非AMI患者作为非AMI组。两组患者均开展H-FABP、cTnI、BNP检测,对比两组BNP、cTnI、H-FABP检测阳性率。结果AMI组发病<3 h患者BNP、cTnI、H-FABP检测阳性率分别为60.0%(36/60)、56.7%(34/60)以及93.3%(56/60);发病3~12 h患者BNP、cTnI、H-FABP检测阳性率分别为85.3%(58/68)、97.1%(66/68)以及97.1%(66/68)。非AMI组患者BNP、cTnI、H-FABP检测阳性率分别为19.2%(20/104)、7.7%(8/104)、9.6%(10/104)。AMI组发病<3 h患者H-FABP检测阳性率均高于BNP、cTnI,发病3~12 h患者H-FABP、cTnI检测阳性率高于BNP,差异具有统计学意义(P<0.05)。AMI组发病3~12 h患者BNP、cTnI检测阳性率均高于发病<3 h,差异具有统计学意义(P<0.05);AMI组发病3~12 h患者H-FABP检测阳性率与发病<3 h对比,差异无统计学意义(P>0.05)。AMI组发病<3 h及3~12 h患者BNP、cTnI、H-FABP检测阳性率均高于非AMI组,差异具有统计学意义(P<0.05)。结论在AMI患者发病后3~12 h联合检测BNP、cTnI以及H-FABP能够在根本上提升AMI检测阳性率,有助于临床早期诊断疾病,因而值得推广。

Objective To analyze the significance of combined detection of heart-type fatty acid binding protein(H-FABP),cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)in early diagnosis of acute myocardial infarction(AMI).Methods 232 patients who visited the emergency department were selected as study subjects,wherein 128 patients with AMI were treated as the AMI group,and 104 patients without AMI were treated as the non-AMI group.H-FABP,cTnI and BNP were detected in both groups,and the positive rates of BNP,cTnI and H-FABP were compared between the two groups.Results In the AMI group,for patients with the onset time<3 h,the positive rates of BNP,cTnI and H-FABP were 60.0%(36/60),56.7%(34/60)and 93.3%(56/60),respectively;for patients with the onset time of 3-12 h,the positive rates of BNP,cTnI and H-FABP were 85.3%(58/68),97.1%(66/68)and 97.1%(66/68),respectively.In the non-AMI group,the positive rates of BNP,cTnI and H-FABP were 19.2%(20/104),7.7%(8/104)and 9.6%(10/104),respectively.For patients with the onset time<3 h in the AMI group,the positive rate of H-FABP was higher than the positive rates of BNP and cTnI,and for patients with the onset time of 3-12 h,the positive rates of H-FABP and cTnl were higher than that of BNP,and the differences were statistically significant(P<0.05).In the AMI group,the positive rates of BNP and cTnI of the patients with the onset time of 3-12 h were higher than those of the patients with the onset time<3 h,and the differences were statistically significant(P<0.05);the difference in the positive rate of H-FABP between patients with the onset time of 3-12 h and patients with the onset time<3 h was not statistically significant(P>0.05).For patients with the onset time<3 h and of 3-12 h in the AMI group,the positive rates of BNP,cTnI and H-FABP were higher than those of samples in the non-AMI group,and the differences were statistically significant(P<0.05).Conclusion The combined detection of BNP,cTnI and h-FABP at 3-12 h after the onset time of patients with AMI can fundamentally increase the positive rates of AMI,which is more conducive to early clinical diagnosis of the disease.Thus,it is worthy of promotion.