心脏型脂肪酸结合蛋白对急性心肌梗死早期诊断价值的研究

选取115例疑诊急性心肌梗死（AMI）的急性胸痛患者，并按胸痛时间分为〈3h和3～6h两个时段，分别进行心脏型脂肪酸结合蛋白（H—FABP）和传统心肌损伤标记物肌钙蛋白T（cTnT）、肌酸激酶同工酶（CK—MB）及肌红蛋白（MYO）检测，比较不同时段检测结果对AMI早期诊断的敏感性及特异性。结果显示，胸痛发生≤6h检测H—FABP对AMI诊断的敏感性显著高于cTnT、CK—MB、MYO（P值分别为0．026、0．005、0．048）；H—FABP的特异性低于cTnT、CK-MB（P〉0．05）。ST段抬高的心肌梗死组与非ST段抬高的心肌梗死组间H—FABP敏感性分别为81．6％、78．1％（P=0．095）。无论胸痛发生〈3h还是3-6h，H—FABP联合cTnT检测对AMI诊断的敏感性均优于cTnT、CK—MB及MYO联合（P值分别为0．005、0．028）。提示，H—FABP在AMI患者早期、快速诊断中具有较高的敏感性，但特异性较差，对早期诊断有参考价值。

Value of heart-type fatty acid binding protein in the clinical diagnosis of early acute myocardial infarction

A total of 115 patients with acute chest pain under the suspicion of＂ acute myocardial infarction （AMI） were selected. By the onset time of chest pain, they were divided into two periods of 〈3 h and 3 -6 h respectively. Heart-type fatty acid binding protein （H-FABP）and such traditional cardiae biochemical markers as cardiac troponin T （cTnT）, creatine kinase isoenzyme （CK-MB） and ruyoglobin （MYO） were tested to compare the sensitivity and specificity in the early diagnosis of AMI. The sensitivity of H-FABP was significantly higher than those of eTnT, CK-MB and MYO （P = 0. 026, 0. 005, 0. 048 ） ; the specificity of H-FABP was lower than those of eTnT, CK-MB in the diagnosis of AMI （P 〉 0. 05）. The sensitivities of H-FABP were 81.6% and 78. 1% in the ST-elevation myocardial infarction （STEMI） and non- ST elevation myocardial infarction （ NSTEMI ） groups respectively （ P = 0. 095 ）. Regardless of the onset of chest pain at 〈 3 h or 3 -6 h, the combination of H-FABP and cTnT had a higher sensitivity than those of cTnT, CK-MB and MYO in the early diagnosis of AMI （ P = 0. 005, 0. 028 ）. In the early and rapid diagnosis of AMI patients, H-FABP has a high sensitivity and a poor specificity. And it has some reference value.