H-FABP和RDW及NT-proBNP水平应用于急性非ST段抬高型心肌梗死诊断的价值分析

  目的  探讨心型脂肪酸结合蛋白(H-FABP)、红细胞体积分布宽度(RDW)及末端脑钠肽前体(NT-proBNP)水平应用于急性非ST段抬高型心肌梗死(NSTEMI)诊断的价值，为临床NSTEMI诊断提供参考。  方法  选择2019年1月—2020年1月首都医科大学附属北京友谊医院急性NSTEMI患者45例作为NSTEMI组，将其按照Gensini积分分为轻度组、中度组及重度组，另选择同期非心源性胸痛、心绞痛患者45例设为非NSTEMI组，健康体检者45例作为对照组。比较各组H-FABP、RDW及NT-proBNP水平差异，分析其单独及联合检测NSTEMI的诊断价值。  结果  NSTEMI组患者H-FABP、RDW、NT-proBNP水平均明显高于非NSTEMI组和对照组，且非NSTEMI组明显高于对照组(均P < 0.05)。重度组H-FABP、RDW、NT-proBNP水平明显高于轻度以及中度组，且中度组明显高于轻度组(均P < 0.05)。NSTEMI患者H-FABP、RDW、NT-proBNP水平与Gensini积分呈正相关(均P < 0.05)。H-FABP、RDW、NT-proBNP单独及联合诊断NSTEMI的AUC值分别为0.813、0.758、0.866、0.887。  结论  血清H-FABP、RDW、NT-proBNP参与急性NSTEMI的发生发展，其水平随急性NSTEMI患者病情加重而逐渐升高，三者联合检测对NSTEMI具有较高诊断价值。 

Application value of H-FABP,RDW and NT-proBNP levels in the diagnosis of acute non ST segment elevation myocardial infarction

  Objective  To investigate the application value of heart-type fatty acid binding protein (H-FABP), red blood cell volume distribution width (RDW) and terminal pro brain natriuretic peptide (NT-proBNP) levels in the diagnosis of acute non ST segment elevation myocardial infarction (NSTEMI) and to provide a reference for the clinical diagnosis of NSTEMI.  Methods  Forty-five patients with acute NSTEMI who were admitted to our hospital from January 2019 to January 2020 were designated as the NSTEMI group, and they were divided into mild, moderate and severe groups according to Gensini score. Forty-five patients with noncardiogenic chest pain and angina pectoris in the same period were designated as non-NSTEMI group. Forty-five healthy people were designated as the control group. The levels of H-FABP, RDW and NT proBNP in each group were compared to analyse the diagnostic value of those in the NSTEMI group.  Results  The levels of H-FABP, RDW and NT-proBNP in the NSTEMI group were higher than those in the non-NSTEMI and control groups, and the levels of H-FABP, RDW and NT-proBNP in the non-NSTEMI group were apparently higher than those in the control group (all P < 0.05). The levels of H-FABP, RDW and NT-proBNP in the severe NSTEMI group were apparently higher than those in the mild and moderate groups, and the levels of H-FABP, RDW and NT-proBNP in the moderate NSTEMI group were apparently higher than those in the mild group (all P < 0.05). The levels of H-FABP, RDW and NT-proBNP in NSTEMI patients were positively correlated with Gensini score (all P < 0.05). The AUC values of PH-FABP, RDW and NT-proBNP alone and in the combined diagnosis of NSTEMI were 0.813, 0.758, 0.866 and 0.887, respectively.  Conclusion  Serum ph-FABP, RDW and NT-probNP participate in the occurrence and development of acute NSTEMI, the level of which increased gradually with the aggravation of the illness of patients with acute NSTEMI. The combined detection of ph-FABP, RDW and NT-probNP have a higher diagnostic value for NSTEMI.