摘要
目的定量分析心肌型脂肪酸结合蛋白（H-FABP）在早期急性心肌梗死（AMI）诊断中的临床应用价值。方法选择因胸痛而就诊的患者120例,最后将确诊AMI患者69例作为AMI组,非AMI患者51例作为对照组,按胸痛发作距就诊时间分为小于3h、3~6h、6h以上3组。采用免疫比浊法定量测定各组H-FABP的水平,同时检测肌酸激酶同工酶（CK-MB）和超敏肌钙蛋白T（hs-cTnT）,比较各指标在诊断AMI早期的敏感度和特异度。结果 AMI组入院后不同胸痛发作时间段的H-FABP水平均高于对照组,差异均有统计学意义（P〈0.05）;AMI组CK-MB和hs-cTnT在胸痛发作3h内检测结果与对照组比较差异无统计学意义（P〉0.05）;在3~6h和6h以上组的检测结果均高于对照组,差异有统计学意义（P〈0.05）。H-FABP的敏感度在发病3h内和3~6h分别为74.1%与87.5%,高于CK-MB（18.5%、54.1%）和hs-cTnT（14.8%、58.3%）,差异有统计学意义（P〈0.05）;发病6h后H-FABP的敏感度为83.3%,低于CK-MB（88.9%）和hs-cTnT（94.4%）,但差异无统计学意义（P〉0.05）。结论 H-FABP定量检测在AMI早期诊断中有较高的敏感度,与其他高特异度指标联合检查可提高AMI的早期诊断准确率。
Objective To study the clinical value of heart-type fatty acid binding protein（H-FABP）in the early diagnosis of acute myocardial infarction（AMI）.Methods Totally 120 cases of patients with chest pain were selected,and the patients with final diagnosis of AMI were 69 cases who were treated as AMI group,and non-AMI patients were 51 cases who were treated as the control group.The patients were also divided into less than 3h,3 to 6h and more than 6h group according to the onset time of chest pain.The level of H-FABP in each group was measured by the method of immune turbidity,and the creatine kinase isoenzyme（CKMB）and super sensitive troponin T（hs-cTnT）were detected.The sensitivity and specificity of three indexes were compared in the early diagnosis of AMI.Results The concentrations of H-FABP in the different periods of AMI group were significantly higher than those of the control group（P〈0.05）.The levels of CK-MB and hs-cTnT of AMI group had no statistical differences with the control group in 3 hours after chest pain（P〈0.05）,while the differences were statistically significant at 3-6h and more than 6h groups（P〈0.05）.The sensitivities of H-FABP in 3 hours and 3 to 6hgroups were 74.1% and 87.5%,which were significantly higher than that of CK-MB（18.5% and 54.1%）and hs-cTnT（14.8% and 58.3%）（P〉 0.05）.The sensitivities of H-FABP at more than 6 hours group was 83.3%,which was lower than that of CK-MB（88.9%）and hs-cTnT（94.4%）,but the differences had no statistical significance（P〈0.05）.Conclusion Quantitative detection of H-FABP in the early diagnosis of AMI has high sensitivity.Combined detection with other high specificity indicators can improve the accuracy of early diagnosis of AMI.
出处
《检验医学与临床》
CAS
2016年第22期3146-3147,3150,共3页
Laboratory Medicine and Clinic
基金
内蒙古自治区科学技术厅资助项目(kjt13sf07)
关键词
肌酸激酶同工酶
心肌型脂肪酸结合蛋白
急性心肌梗死
超敏肌钙蛋白T
creatine kinase isoenzyme
heart-type fatty acid binding protein
acute myocardial infarction
super sensitive troponin T
