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目的评价定量检测血清心脏型脂肪酸结合蛋白(hearttypefattyacidbindingprotein,HFABP)对判断慢性充血性心力衰竭严重程度的临床价值。方法采用酶联免疫吸附试验一步夹心法检测18名健康体检者、76例慢性心力衰竭患者(纽约心脏病学会心功能分级Ⅱ级24例、Ⅲ级29例、Ⅳ级23例)的血清HFABP,同时测定心肌肌钙蛋白I(cardiactroponinI,cTnI)、肌酸激酶同工酶MB(creatinekinaseisoenzymeMB,CKMB),并作比较。结果随着心力衰竭程度的加重,慢性心力衰竭患者HFABP、cTnI、CKMB的血清浓度逐渐升高,心功能Ⅱ级、Ⅲ级、Ⅳ级患者的HFABP值分别为(32±16)μg/L,(67±17)μg/L,(95±20)μg/L;cTnI值分别为(023±007)μg/L,(045±011)μg/L,(076±019)μg/L;CKMB值分别为(136±31)U/L,(145±44)U/L,(163±39)U/L,均为P<005;治疗后,随病情好转,HFABP、cTnI的血清浓度明显下降[治疗后心功能Ⅱ级、Ⅲ级、Ⅳ级患者的HFABP值分别为(28±15)μg/L,(31±13)μg/L,(56±13)μg/L;cTnI值分别为(016±008)μg/L,(036±007)μg/L,(057±010)μg/L],P<005;CKMB值在治疗前、后差异无统计学意义。结论血清HFABP可作为判断慢性充血性心力衰竭严重程度的可靠指标。
Objective To evaluate the clinical value of quantitative detection of serum heart type fatty acid binding protein (HFABP) in judging the severity of chronic congestive heart failure. Methods Serum levels of HFABP were measured by enzyme-linked immunosorbent assay (ELISA) in 18 healthy subjects, 76 patients with chronic heart failure (New York Heart Association Society of Cardiology, grade Ⅱ 24, grade Ⅲ 29, and grade Ⅳ) Cardiac troponin I (cTnI) and creatine kinase isoenzyme MB (CKMB) were also measured and compared. Results The HFABP, cTnI and CKMB levels in patients with chronic heart failure increased gradually with the severity of heart failure. The HFABP values in patients with grade Ⅱ, Ⅲ and Ⅳ cardiac function were (32 ± 16) μg / L, (67 ± 17) μg / L and (95 ± 20) μg / L, respectively. The values of cTnI were (023 ± 007) μg / L, (136 ± 31) U / L, (145 ± 44) U / L and (163 ± 39) U / L, respectively, all P <005. After treatment, the serum concentrations of HFABP and cTnI were significantly increased (HFABP values of (28 ± 15) μg / L, (31 ± 13) μg / L, (56 ± 13) μg / L, respectively) after treatment for patients with grade Ⅱ, Ⅲ, (016 ± 008) μg / L, (036 ± 007) μg / L, (057 ± 010) μg / L], P <005. There was no significant difference in CKMB before and after treatment. Conclusion Serum HFABP can be used as a reliable indicator of the severity of chronic congestive heart failure.