心肌脂肪酸结合蛋白在早期急性心肌梗死诊断中的临床价值

目的探讨心肌脂肪酸结合蛋白（H-FABP）在早期急性心肌梗死（AMI）诊断中的临床价值。方法检测111例0-3h内和0-6h内胸痛发作患者的血清H-FABP、cTnI和CK-MB水平,其中急性心肌梗死（AMI）40例、非急性心肌梗死（NO-AMI）36例、非心源性胸痛（NCCP）35例,同期选择37例体检健康者为对照组。比较各组0-3h内和0-6h内胸痛发作患者H-FABP的表达水平,观察H-FABP、cTnI和CK-MB诊断AMI的敏感性和特异性。结果 0-3h内和0-6h内AMI组H-FABP水平表达（38.14±24.18）ng/mL和（73.35±56.73）ng/mL均明显高于其他各组（P〈0.01）;H-FABP诊断发病3h和6h内AMI的敏感性显著高于cTnI和CK-MB（P〈0.05）,特异性比较无显著差异性（P〉0.05）。结论 H-FABP诊断早期急性心肌梗死的敏感性优于cTnI和CK-MB,可作为一种有效诊断指标。

Clinic value of heart-type fatty acid-binding protein on diagnosis of early acute myocardial infarction

Objective To investigate the clinic value of heart-type fatty acid-binding protein（H-FABP） on diagnosis of early acute myocardial infarction.Methods The H-FABP、cTnI and CK-MB levels were measured within 3h or within 6h after onset of chest pain in 111 patients.With 40 cases of acute myocardial infarction（AMI）,36 cases of no-acute myocardial infarction（NO-AMI）,35 cases of non-cardiac chest pain（NCCP）,at the same period 27 healthy volunteers were selected as the control group.The expression levels of H-FABP in within 3h or within 6h after onset of chest pain patients were compared,and the sensitivity and specificity of H-FABP,cTnI and CK-MB on diagnosis of AMI.Results The expression levels of H-FABP within 0-3 h and 0-6 h （38.14±24.18） ng/mL and（73.35±56.73） ng/mL] were significantly higher than those of the other groups（P0.01）.The sensitivity of H-FABP in diagnosis of AMI within 0-3 h and 0-6 h were significantly higher than those of cTnI and CK-MB（P0.05）.There was no significant difference between the specificity（P0.05）.Conclusion The sensitive of H-FABP in diagnosis of early acute myocardial infarction was more than that of cTnI and CK-MB.It could be used as an effective diagnostic index.