急性高血压脑出血患者血清h-FABP水平变化及其临床应用价值

目的 通过观察急性高血压脑出血患者血清心脏型脂肪酸结合蛋白(h-FABP)水平变化,探讨其临床检测价值.方法 血清h-FABP采用双抗体夹心酶联免疫一步法定量检测;cTnI采用固相酶联免疫吸附实验(ELISA);CK-MB采用免疫抑制法测定HT5H〗结果 急性高血压脑出血患者组血清h-FABP水平显著高于对照组(P<0.01),大量出血者及意识不清者血清h-FABP水平分别显著高于小量出血者及意识清醒者(P<0.01);血清h-FABP阳性率显著高于血清cTnI、CK-MB及心电图的阳性率(P<0.01);死亡率为25.5%(28/110),血清h-FABP、cTnI、CK-MB及心电图异常组的死亡率显著高于正常组(P<0.01);血清h-FABP预测发生死亡具有高的敏感性和阴性预测值,特异性和准确度较低,但心电图具有较高的特异性(64.5%)和准确度(69.1%).结论 血清h-FABP定量测定可作为判断急性高血压脑出血病情轻重及评价发生意外的1项客观指标,联合心电图监测临床价值更高.

Changes and clinical value of heart-type fatty acid binding protein in patients with acute hypertensive cerebral hemorrhage

Objective To understand the clinical value of heart-type fatty acid binding protein (h-FABP) in patients with acute hypertensive cerebral hemorrhage(AHCE) through the variation analysis of its serum level.Methods Serum level of h-FABP was determined by enzyme-linked immunosorbent one-step quantitative detection,cardiac troponin I(cTnI) was detected by solid-phase enzyme-linked immunosorbent assay (ELISA) and isoenzyme MB of creatine kinase(CK-MB) was assayed by immunosuppression assay.Results The h-FABP level in(AHCE) group was significantly higher than healthy control group(P<0.01) and that in AHCE patients with massive haemorrhage and unconsciousness was significantly higher than in patients with small heamorrhage and consciousness.The positive rate of h-FABP was significantly higher than cTnI,CK-MB and electrocardiogram(P<0.01).The mortality rate in patients,with abnormality of serum level of h-FABP,cTnI and CK-MB and ECG,was higher than patients without the abnormality,mentioned above (P<0.01).The sensitivity and negative predictive value of serum h-FABP for the prediction of fatality were high,but with low specificity and accuracy,although the specificity and accuracy of ECG were relatively higher,with 64.5% and 69.1% respectively.Conclusion Quantitative detection of serum h-FABP could be an objective indicator for the judgement of disease condition and the evaluation of accidental risk of AHCE,with more clinical application value,when being combined with ECG inspect.