摘要
目的探究早期心型脂肪酸结合蛋白(heart-type fatty acid binding protein,h-FABP)与血栓弹力图联合检测对急性心肌梗死预后的评估价值。方法选择2015年2月至2017年12月包头市中心医院心血管内科收治的急性心肌梗死早期行h-FABP及血栓弹力图检测的患者176例,依据随访12个月是否发生主要心血管不良事件(major adverse cardiovascular events,MACE)分为MACE组(47例)和无MACE组(129例),比较两组患者h-FABP水平和血栓弹力图参数R、α角、MA值、CI水平,分析h-FABP水平和血栓弹力图参数与急性心肌梗死预后的关系。结果两组一般资料比较差异无显著性(P>0.05);两组h-FABP及血栓弹力图参数R、α角、MA值、CI水平比较差异有显著性(P<0.05);ROC曲线分析显示,h-FABP与血栓弹力图参数R、α角、MA值、CI单一项的曲线下面积分别为0.923、0.736、0.843、0.785、0.643,各指标最佳截断点分别为75.36μg/L、5.34min、68.63ο、64.37mm、1.39。h-FABP与血栓弹力图联合检测时曲线下面积为0.962;联合h-FABP与血栓弹力图评估MACE的敏感度为95.74%,特异度为96.90%,阳性预测值为91.94%,阴性预测值为98.43%,准确率为96.59%。结论早期联合检测h-FABP与血栓弹力图对急性心肌梗死预后有很好的预测价值。
Objective To evaluate the value of early detection combined detection of heart-type fatty acid binding protein(h-FABP)and thromboelastography(TEG)in early evaluating prognosis of acute myocardial infarction(AMI).Method Totally 176 cases who were tested h-FABP,TEG in the early stage of AMI were divided into MACE group(47 cases)and non-MACE group(129 cases)according to the occurence of major adverse cardiovascular events(MACE)within 12 months of follow-up.To analyze the relationship between h-FABP,TEG(parameters:R,αangle,MA value,CI)and prognosis of AMI.Result There was no significant difference in general data between the two groups(P>0.05);There were significant differences in h-FABP and TEG parameters R,αangle,MA value and CI level between the two groups(P<0.05);ROC curves showed that the underlying areas of h-FABP and R,αangle,MA value and CI were 0.923,0.736,0.843,0.785 and 0.643,respectively,and the best cut-off points of each index were 75.36μg/L,5.34min,68.63ο,64.37mm,1.39,respectively.AUC was 0.962 when combined detection of h-FABP and TEG.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of combined h-FABP and TEG in evaluating MACE were 95.74%,96.90%,91.94%,98.43%and 96.59%,respectively.Conclusion Early detection h-FABP combined TEG has a good predictive value for the prognosis of AMI.
作者
金慧
乌日娜
JIN Hui;WU Ri-na(Department of Cardiovascular Medicine,Baotou Central Hospital,Inner Mongolia Baotou,014040)
出处
《中国医刊》
CAS
2020年第2期155-158,共4页
Chinese Journal of Medicine
基金
内蒙古自治区科技厅计划项目（20080502）
关键词
急性心肌梗死
心型脂肪酸结合蛋白
血栓弹力图
评估预后
Acute myocardial infarction
Heart-type fatty acid binding protein
Thromboelastography
Evaluate prognosis
