论文部分内容阅读
目的:探讨血清心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)在急性心肌梗死(acute myocardial infarction,AMI)早期诊断中的应用价值。方法:应用乳胶凝集法检测105例因胸痛疑似AMI就诊患者的血清H-FABP,同时测定患者血清中肌酸激酶同工酶MB(creatine kinase isoenzyme MB,CK-MB)、肌红蛋白(myoglobin,MYO)和心肌钙蛋白I(cardiac troponinc I,c Tn I)。根据最终的临床诊断将患者分为AMI组和非AMI组(对照组),并对2组检测结果的阳性率、诊断效率等进行分析比较。结果:105例疑似AMI患者中,最终诊断为AMI患者45例,其余60例排除AMI诊断作为对照组。AMI组的H-FABP、c Tn I、MYO、CK-MB平均水平及阳性率分别为(49.32±10.29)ng/m L、84.4%,(1.62±0.76)ng/m L、44.4%,(156.14±54.23)ng/m L、82.2%,(13.01±6.08)ng/m L、42.2%,均高于对照组(P<0.05);AMI组中H-FABP阳性率与MYO阳性率间无统计学差异(P>0.05),但明显高于c Tn I及CK-MB的阳性率(P<0.05)。H-FABP与CK-MB诊断AMI的特异度相似(P>0.05),但低于c Tn I(P<0.05),高于MYO(P<0.05)。H-FABP与c Tn I的阳性预测值相似(P>0.05),均高于MYO、CK-MB(P<0.05)。在阴性预测值方面,H-FABP与MYO相似(P>0.05),明显高于c Tn I和CK-MB(P<0.05)。4项指标检测结果进行组合分析,H-FABP+c Tn I、H-FABP+CK-MB、H-FABP+MYO、H-FABP+c Tn I+MYO、H-FABP+c Tn I+CK-MB、H-FABP+c Tn I+MYO+CK-MB诊断AMI的灵敏度均为100.0%,特异度分别为82.0%、72.0%、61.2%、59.3%、68.1%和56.5%。结论:H-FABP在AMI早期诊断中具有较好的灵敏度和特异度,与c Tn I联合检测,可显著提高AMI早期诊断效能。
Objective: To investigate the value of serum-type fatty acid-binding protein (H-FABP) in the early diagnosis of acute myocardial infarction (AMI). Methods: The serum H-FABP level in 105 cases of suspected AMI patients with chest pain was detected by latex agglutination. The levels of serum creatine kinase isoenzyme MB (CK-MB), myoglobin MYO) and cardiac troponin I (c Tn I). According to the final clinical diagnosis, patients were divided into AMI group and non-AMI group (control group). The positive rate and diagnostic efficiency of the two groups were analyzed and compared. Results: Of the 105 suspected AMI patients, 45 were eventually diagnosed as AMI and the remaining 60 were excluded as controls. The mean and positive rates of H-FABP, cTn I, MYO and CK-MB in AMI group were (49.32 ± 10.29) ng / m L, 84.4%, 1.62 ± 0.76 ng / m L and 44.4% 156.14 ± 54.23 ng / m L, 82.2%, (13.01 ± 6.08) ng / m L, 42.2%, respectively) were higher than those in the control group (P <0.05). There was no difference between the positive rates of H-FABP and MYO in the AMI group (P> 0.05), but it was significantly higher than that of cTn I and CK-MB (P <0.05). The specificity of H-FABP and CK-MB in diagnosing AMI was similar (P> 0.05), but lower than cTnI (P <0.05) and higher than MYO (P <0.05). The positive predictive values of H-FABP and cTn I were similar (P> 0.05), which were higher than those of MYO and CK-MB (P <0.05). In negative predictive value, H-FABP was similar to MYO (P> 0.05), significantly higher than cTn I and CK-MB (P <0.05). H-FABP + c Tn I, H-FABP + CK-MB, H-FABP + MYO, H-FABP + c Tn I + MYO, H-FABP + c Tn I + CK The sensitivity and specificity of AM-MB and H-FABP + c Tn I + MYO + CK-MB diagnosis were 100.0%, 82.0%, 72.0%, 61.2%, 59.3%, 68.1% and 56.5% respectively. Conclusions: H-FABP has good sensitivity and specificity in the early diagnosis of AMI. Combined with cTn I can significantly improve the early diagnosis of AMI.