心型脂肪酸结合蛋白对急性心肌梗死患者心功能的评估价值

目的探讨心型脂肪酸结合蛋白（heart fatty acid- binding proteins, H - FABP）对急性心肌梗死（acute myocardial infarction，AMI）患者心功能的评估价值。方法入选2011年4月-2013年3月我科确诊AMI患者74例并记录患者临床资料，于确诊时即采集静脉血测定H—FABP水平。根据其测定值将患者分为二组，A组：H—FABP〈65ng／ml；B组：H—FABP≥65ng／m1。比较二组间临床资料及确诊后30d、180d时左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、心衰超声指数及不良心血管事件的发生情况。结果二组问临床资料比较差异无统计学意义（P〉0．05）；A组确诊后30d及180d时LVEF均比B组高而LVEDD、LVESD及心衰超声指数均比B组低，二者之间的差异有统计学意义（P〈0．01）；确诊后30d及180d时，A组不良心血管事件发生率低于B组（P〈0．05）。其中A组严重心力衰竭发生率低于B组（P〈0．05）；A组恶性心律失常、心源性死亡的发生率、再发心肌梗死及靶病变血管重建的发生率低于B组，但二组间差异无统计学意义（P〉0．05）。结论H—FABP的测定为评价AMI患者的短期及长期心功能提供了客观的信息，具有广阔的临床推广价值。

THE VALUE OF THE HEART FATTY ACID - BINDING PROTEINS IN ASSESSMENT ON CARDIAC FUNCTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective To analyze the value of the heart fatty acidbinding proteins in assessment of cardiac function in patients with acute myocardial infarction. Methods Between April 2011 and March 2013, 74 patients confirmed AMI in author＇s department were recorded of clinical data and taken venous blood for the test of H - FABP while diagnosis was confirmed. According to the test results, the patients were divided into two groups： group A （H - FABP〈65ng/ml）, group B （H - FABP≥65ng/ml）. To compare the clinical data, left ventricular ejection fraction（LVEF）, left ventricular enddiastolic diameter（LVEDD）, left ventricular end systolic diameter（LVESD）, heart failure echocardiograph index and the major adverse cardiac events（including recurrent myocardial infarction, cardiac deaths, malignant arrhythmias, severe heart failure and target vessel revascularization） at 30 days and 180 days after diagnosis, and to evaluate the rela- tionship between H - FABP and the changes of cardiac function of patients with AMI in shortterm period and long- term period. Results There were no significant difference between the two groups about the clinical data（P〉0.05）. At 3（1 days and 180 days after diagnosis, compared to group B, LVEF was higher and LVEDD, while LVESD and heart failure echocardiograph index were lower in group A （P〈0.01） ; the incidence of major adverse cardiac events was less obviously in group A than that in group B （P〈0.05） ; in which the incidence of severe heart failure was much lower in group A than that in group B （P〈0.05）, but no significant difference was found between the groups on malignant arrhythmia, target vessel revascularization, recurrent myocardial infarction and cardiac mortality（P〉0.05）. Conclusions The H - FABP can provide short and long term cardiac function information for patients with AMI, and the clinical value is expected to be spread in patients with AMI.