H-FABP在先天性心脏病介入治疗中的变化及临床意义

目的观察先天性心脏病介入封堵术中血清心肌型脂肪酸结合蛋白（H—FABP）的动态变化，研究使用国产封堵器进行心导管介入治疗后心肌损伤的情况。方法随机选取先天性心脏病（先心病）介入治疗的患者102例，动态监测H—FABP的变化。结果102例先心病患儿血清H—FABP术后15min升高达峰值，术后4h开始下降，24h基本恢复。术前及术后5-15min、4h、24h分别为（1．24±0．21）ng／ml、（8．13±1．49）ng／ml、（5．35±0．18）ng／ml、（1．03±0．18）ng／ml，各时间点差异有统计学意义（P〈0．01）。结论先心病介入封堵术可引起可逆性的心肌微损伤，血清H—FABP是监测早期心肌损伤的可靠指标，可为临床防治术后并发症提供科学依据。

The dynamic monitoring study on heart fatty acid-binding protein during cardiac catheterization in congenital heart diseases

Objective To investigate myocardial damage degree in patients with congenital heart diseases by monitoring the changes of heart fatty acid-binding protein （H-FABP） during cardiac catherization with domestic occluder. Methods 102 patients with congenital heart diseases occluding were randomly divided into three groups according to pathological type. The serum levels of H-FABP in all patients were measured at four time points from preoperative day to next day. Results The serum H-FABP concentrations at 15 min before and after the operation, at 4 h and 24 h were （1.31±0.21）ng/ml, （8.13±1.49）ng/ml, （5.35±0.18）ng/ml and （1.06±0.18） ng/ml respectively, and there were significant differences among the four time points （P〈0.01）. Conclusion The intervention therapy for congenital heart diseases might result in slight injury on myocardium, and serum H-FABP is an early and sensitive marker for predicting myocardial injury . The detection of H-FABP could provide scientific basis for preventing the complications after the operation.