心脏型脂肪酸结合蛋白在急性心肌梗死早期诊断中的应用

    Heart-type fatty acid binding protein in early diagnosis of acute myocardial infarction

    • 摘要: 目的:探讨心脏型脂肪酸结合蛋白(H-FABP)在急性心肌梗死(AM I)早期诊断中的价值。方法:将60例AM I患者按发病时间不同分为2组,分别在发病0~3 h、4~6 h内检测H-FABP、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)的含量,计算各项指标的灵敏度、特异度、阳性预测值及阴性预测值,并与正常对照组和冠心病心绞痛组进行比较分析。结果:0~3 h及4~6 h AM I组的血浆H-FABP浓度均明显高于正常对照组及冠心病心绞痛组(P<0.01),在发病0~3 h及4~6 h内H-FABP诊断AM I的阳性率分别为67.74%和89.66%均高于cTnI(29.03%、62.07%)和CK-MB(0.00%、58.62%)(P<0.01~P<0.05);0~3 h内H-FABP的阳性预测值及阴性预测值为91.30%和86.84%,CK-MB为0.00%和68.69%;在0~3 h及4~6 h内H-FABP诊断AM I的特异度均为97.06%,cTnI和CK-MB的特异度为98.53%和100.00%。结论:H-FABP较cTnI和CK-MB更具有早期诊断AM I的临床应用价值。

       

      Abstract: Objective:To assess the value of heart-type fatty acid binding protein (H-FABP) in early diagnosis of acute myocardial infarction (AMI).Methods:Sixty cases of AMI patients were divided into 2 groups according to the time of receiving treatment.The H-FABP,cTnI and CK-MB were detected 0-3 hours and 4-6 hours after the onset.The sensitivity,specificity,positive predictive value and negative predictive value were calculated,and the results were analyzed and compared with those of the normal control and the angor pectoris group.Results:The level of plasma H-FABP concentration in the AMI patients receiving treatment 0-3 hours and 4-6 hours after onset was significantly higher than that of the the control group and the angor pectoris group (P<0.01);the sensitivity of H-FABP within 0-3 hours and 4-6 hours of onset was 67.74% and 89.66%,respectively in diagnosis of AMI,which was significantly higher than that of cTnI (29.03%,62.07%) and CK-MB (0.00%,58.62%) (P<0.01 and P<0.05);the positive predictive value and negative predictive value of H-FABP were 91.30% and 86.84%,CK-MB within 0-3 hours of onset were 0.00% and 68.69%.The specificity value of H-FABP within 0-3 hours and 4-6 hours of onset was 97.06%,which was similar to that of cTnI and CK-MB in diagnosis of AMI were 98.53% and 100.00%.Conclusions:H-FABP is superior to cTnI and CK-MB in diagnosis of AMI.

       

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