H-FABP、NT-proBNP、cTnT和CK-MB在急性心肌梗死早期诊断中的价值比较

目的通过测定心型脂肪酸结合蛋白（H-FABP）、N-末端脑钠肽（NT-proBNP）、肌钙蛋白T（cTnT）和肌酸激酶同工酶（CK-MB）在急性心肌梗死（AMI）患者的早期诊断效率,对几种标志物在AMI早期诊断中的价值进行比较。方法测定84例AMI患者和72例不稳定型心绞痛（UA）患者血浆H-FABP、NT-proBNP、cTnT和CK-MB含量,各组之间进行比较,通过ROC曲线计算4种标志物在AMI早期诊断中的诊断效率、灵敏度、特异度和阴阳性预测值,比较几种标志物对AMI早期诊断价值。结果 AMI组的H-FABP、NT-proBNP、cTnT和CK-MB水平都明显高于UA组,两组比较,差异有统计学意义（P〈0.05）。在AMI诊断上,H-FABP是4种标志物中诊断效率、灵敏度和阴性预测值最高的,cTnT是特异度和阳性预测值最高的,所有标志物诊断效率均具有统计学意义（P〈0.01）。结论在AMI早期诊断上,4种标志物联合检测特别是H-FABP和cTnT联合检测能够明显提高AMI的诊断效率。

The value comparison between H-FABP, NT-proBNP, cTnT and CK-MB in early stage diagnosis of the acute myocardial infarction

Objective To measuring the early diagnostics efficiency of heart-type fatty acid-binding protein （ H-FABP）, amino-terminal pro-brain natriuretic peptide （NT-proBNP）, cardiac troponin T （cTnT） and creatine kinase-MB （CK-MB） in acute myocardial infarction （AMI） and compare theirs diagnostic value of early stage AMI. Methods The plasma of 84 AMI patients and 72 unstable angina （UA） patients were collected and the concentration of H-FABP, NT-proBNP, cTnT and CK-MB were detected between AMI group and UA group. Through the ROC curves study the diagnostic efficiency, sensitivity, specificity, positive predictive value and negative predictive value of the four markers in early stage diagnosis of the acute myocardial infarction and compare the diagnosis value of the four markers. Results The level of H-FABP, NT-proBNP, cTnI and CK-MB were significantly higher in AMI group than UA group, the difference between two groups showed statistical significance （ P 〈 0. 05 ）. In the diagnosis of AMI, the diagnostic efficiency, sensitivity and negative predictive value of H-FABP were the highest and the specificity, positive predic- tive value of cTnT were the highest. The diagnose efficiency of all markers showed statistical significance （ P 〈 0.01 ）. Conclusion The levels of four markers especially H-FABP and cTnT can improve the diagnostic efficiency of AMI.