摘要
目的:探讨心肌型脂肪酸结合蛋白(heart type-fatty acid binding proteins,H-FABP)在冠状动脉粥样硬化性心脏病(以下简称冠心病)急性心肌梗死(acute myocardial infarction,AMI)超急性期诊断中的准确度及其临床应用价值。方法:采用双抗体夹心酶联免疫附试验(enzyme-linked immunosorbent assay,ELISA)法测定136例发病2 h内入院的胸痛患者血清H-FABP和超敏心肌肌钙蛋白(hypersensitivity cardiac troponini I,hs-c Tn I)、心肌肌酸激酶同工酶(creatine kinase-MB,CKMB)水平,绘制上述3个指标受试者工作特征(receiver operating characteristic,ROC)曲线,比较曲线下面积(area under curve,AUC),计算敏感性和特异性,并统计临床确诊的70例AMI患者与66例非AMI患者的血清H-FABP、CK-MB、hs-c Tn I水平差异。结果 :胸痛2 h内AMI患者与非AMI患者的血清H-FABP、CK-MB、hs-c Tn I水平差异均存在统计学意义(P<0.01),ROC曲线显示H-FABP对超急性期AMI诊断的敏感性和特异性均高于CK-MB和hs-c Tn I。结论:HFABP在AMI患者的超急性期敏感性和特异性优于CK-MB、hs-c Tn I,是优秀的超早期AMI诊断指标,非常有利于超急性期AMI的诊断与排除,血清H-FABP监测对AMI早期诊断具有重要的临床价值。
Objective：To investigate the accuracy and clinical value of heart fatty acid binding protein（H-FABP） in the diagnosis of acute myocardial infarction（AMI）in patients with coronary heart disease. Methods： The serum levels of H-FABP, hypersensitivity cardiac troponin I（hs-cTnI）, and c reatine kinase-MB（CK-MB） in 136 patients with acute chest pain hospitalized within 2 hours were determined by double antibody sandwich enzyme-linked immunosorbent assay（ELISA）. The receiver operating characteristic（ROC） curve of three above biomarkers was drawn and the area under the curve（AUC）, sensitivity, and specificity was compared between the AMI group confirmed（70 patients） and non-AMI group（66 patients）. Results： The serum levels of H-FABP, CK-MB, and hs-cTnI within 4 hours were significantly different between AMI patients and non-AMI patients（P〈0.01）. ROC showed that the sensitivity and specificity of H-FABP in the diagnosis of ultra early AMI were higher than those of CK-MB and hs-cTnI. Conclusion： The accuracy of H-FABP in diagnosis of the early stage of AMI is significantly higher than that of CK-MB and hs-cTnI. The examination of H-FABP is very conducive to the diagnosis of hyperacute AMI and has important clinical value for early diagnosis of AMI.
作者
袁晓宇
黄中伟
YUAN Xiaoyu HUANG Zhongwei(Department of Emergency Medicine, the Affiliated Hospital of Nantong University, Nantong 226001)
出处
《南通大学学报（医学版）》
2016年第6期525-528,共4页
Journal of Nantong University(Medical sciences)
基金
国家自然科学基金资助项目(81302056)
