血清心肌型脂肪酸结合蛋白快速检测急性心肌梗死的敏感度和特异度分析

目的:分析血清心肌型脂肪酸结合蛋白(H-FABP)快速检测对急性心肌梗死(AMI)早期诊断的敏感度和特异度。方法:53例胸痛患者,经确诊分为AMI组(包括发病<6h和6～12h两亚组)和非AMI组,平行检测H-FABP、肌红蛋白(MYO)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB),计算H-FABP等指标诊断AMI的敏感度和特异度。结果:H-FABP诊断发病<6h AMI的敏感度为85.71%,与MYO的80.95%相近,明显高于cTnI的47.62%和CK-MB的52.38%,差异有统计学意义(P<0.05);AMI发病6～12h,H-FABP诊断AMI的敏感度为100.00%,略高于MYO、cTnI和CK-MB(均为92.86%),但差异无统计学意义(P>0.05)。H-FABP等指标诊断AMI的特异度无论非AMI组还是健康对照组,各指标间差异均无统计学意义(P>0.05)。结论:H-FABP对AMI早期诊断有较高的敏感度和特异度,可作为AMI早期筛查及诊断指标。

The Sensitivity and Specificity Analysis of Serum Heart-Type Fatty Acid-Binding Protein for Diagnosis of Acute Myocardial Infarction

Objective:To analysis the sensitivity and specificity of heart-type fatty acid-binding protein(H-FABP) for early diagnosis of acute myocardial infarction(AMI).Method:Thirty-five confirmed AMI patients were observed,the serum levels of H-FABP,cardiac troponin I(cTnI),creatine kinase MB isoenzyme(CK-MB),myoglobin(MYO) were detected in <6h and 6-12h after onset of chest pain,and the sensitivity of the four markers was calculated.The specificity was compared with 18 uncertain AMI patients and 40 healthy subjects.Results:The early diagnostic sensitivity of H-FABP in <6h was 85.71% in AMI,which was significantly higher than that of cTnI(47.62%) and CK-MB(52.38%)(P<0.05).The diagnostic sensitivity of H-FABP,MYO,cTnI,CK-MB in 6-12h was 100.00%,92.86%,92.86%,92.86% respectively(P>0.05).There was no significant difference in the specificity among the four markers(P>0.05).Conclusion:H-FABP has more sensitivity and specificity in the early diagnosis of AMI,which can be an important myocardial marker for both early screening and early diagnosis of AMI.