摘要
目的研究心脏型脂肪酸结合蛋白(H-FABP)、高敏肌钙蛋白(hs-cTnI)、同型半胱氨酸(Hcy)和胱抑素C(Cys-C)在急性心肌梗死(AMI)早期诊断中的临床价值。方法选择该院心血管内科收治的胸痛发作6h内入院的AMI患者150例(AMI组),对照组30例,测定各组血清中四种新型心肌标志物水平。结果 AMI组患者发病6h内血清中H-FABP、hs-cTnI、Hcy和Cys-C水平显著高于对照组(P<0.05),并随冠状动脉血管病变支数增加而升高,差异均有统计学意义(P<0.05)。各心肌标志物对AMI诊断的特异度均较高,H-FABP和hs-cTnI敏感度较其他标志物显著增高,分别为97.34%和89.98%,结合Youden指数、阳性似然比、阴性似然比、阳性预测值和阴性预测值可以看出,H-FABP和hs-cTnI对AMI的诊断价值高,Hcy和Cys-C对AMI的诊断价值较低。结论 H-FABP和hs-cTnI是诊断早期(发病6h以内)AMI最敏感的指标,具有非常重要的临床应用价值。H-FABP、hs-cTnI、Hcy和Cys-C水平随冠状动脉血管病变支数增加而升高。
Objective To study the clinical value of heart‐type fatty acid binding protein（H‐FABP） ,high‐sensitive cTnI（hs‐cT‐nI）,homocysteine（Hcy）andcystatinc（Cys‐C）intheearlydiagnosisofacutemyocardialinfarction（AMI）.Methods 150casesof AMI patients with coronary arteriography （AMI group） were selected from the cardiovascular department admitted within the first 6hours of chest pain attack .An additional 30 case for control group .The level of four novel cardiac marker were measured in each group of serum .Results The level of serum H‐FABP ,hs‐cTnI ,Hcy and Cys‐C in AMI group were markedly higher than control group（P〈0 .05） ,and rose with the increase of coronary artery lesions with statistical difference （P〈0 .05） .Each cardiac markers showed high specificity in the diagnosis of AMI ,amongst which H‐FABP and hs‐cTnI ,stood out with sensitivity of 97 .34% and 89 .98% respectively .With Youden index ,positive likelihood ration ,negative likelihood ration ,positive predictive value and negative predictive value ,H‐FABP and hs‐cTnI appeared to have higher diagnostic value than Hcy and Cys‐C in AMI .Conclusion H‐FABP and hs‐cTnI displayed significant clinical value as a most sensitive indicator in the early diagnosis of AMI （within 6 hours of attack） . The level of H‐FABP ,hs‐cTnI ,Hcy and Cys‐C elevated as coronary artery lesions increase .
出处
《国际检验医学杂志》
CAS
2015年第15期2170-2171,2174,共3页
International Journal of Laboratory Medicine
基金
庆阳市科技支撑计划项目(kz2014-53)
关键词
心脏型脂肪酸结合蛋白
高敏肌钙蛋白
急性心肌梗死
早期诊断
heart-type fatty acid binding protein
high-sensitive cTnI
acute myocardial infarction
early diagnosis
