心肌型脂肪酸结合蛋白在急性心肌梗死早期诊断中的应用

The value of heart-type fatty acid-binding protein for early detection of acute myocardial infarction

目的 评定脂肪酸结合蛋白 (H FABP)在急性心肌梗死 (AMI)早期诊断中的应用。 方法 采用自行开发的H FABP酶联免疫吸附试验一步夹心法对 12 6名健康体检者和 5 3例AMI患者血清H FABP进行检测 ,同时测定肌红蛋白 (MYO)、肌酸激酶同工酶 (CK MB)、肌钙蛋白I(cTnI) ,并对AMI进行动态观察 ,对早期诊断的敏感性、特异性、时效性等进行分析。 结果 H FABP在AMI后 (1 84± 0 6 4 )h血浆浓度即开始升高 ,比CK MB、cTnI早 (P <0 0 1) ;时间浓度动态曲线与MYO相似 ,与CK MB、cTnI相比曲线前移。AMI后 2h的敏感性和特异性分别为 76 4 7%、80 4 1% ;4h的敏感性和特异性分别为 89 16 %、91 2 6 %。 结论 AMI后 2、4hH FABP检测对AMI早期诊断具有较高的敏感性和特异性 ,可望成为重要的早期和排除诊断的血清心肌标志物的手段之一。

Objective To evaluate the diagnostic value of H-FABP for early detection of acute myocardial infarction(AMI). Methods Serum H-FABP of 126 healthy individuals and 53 AMI patients were measured by self developed ELISA. MYO, cTnI and CK-MB, traditional biochemistry diagnostic markers were estimated at the same time. The dynamic movement of these myocardial indicators for AMI patients, and their diagnostic sensitivity and specificity in the earlier period of AMI onset was analyzed. Results The plasma concentration of H-FABP began to increase at (1.84±0.64) h after AMI onset, earlier than CK-MB and cTnI. The time-concentration dynamic curves of H-FABP was similar to that of MYO and moved to left in comparison with both CK-MB and cTnI. The sensitivity and specificity of H-FABP at 2 h after AMI were 76.47% and 80.41%, and 89.16% and 91.26% at 4 h, respectively;. Conclusions H-FABP is more sensitive and specific in the early diagnosis of AMI within 2 hours and at 4 hours after symptom onset. It is hoped that H-FABP become an important myocardial marker for both early diagnosis and elimination diagnosis of AMI.