心脏型脂肪结合蛋白的研究及在心脏外科的应用

背景：心脏型脂肪结合蛋白是心肌细胞胞浆中含量最丰富的蛋白质之一,是心肌损伤的标志蛋白。目的：归纳总结心脏型脂肪结合蛋白的生物学结构及功能、代谢动力学、临床研究进展及其在心脏外科的应用。方法：由第一作者检索1983-01/2010-12 PubMed数据及维普数据库与心脏型脂肪结合蛋白的生物学结构及功能有关的文献,心脏型脂肪结合蛋白在心脏外科中的应用及临床上应用相关文献。英文检索词为“heart fatty acid-binding protein,creatine kinaseisoenzyme, acute myocardial infarction,coronary artery bypass grafting”;中文检索词为“心脏型脂肪结合蛋白,肌酸激酶同工酶,心肌梗死,冠状动脉旁路移植术”。根据纳入标准保留62篇进行论述。结果与结论：心脏型脂肪结合蛋白是一种低分子量的可溶性蛋白,较特异的存在于心肌细胞质内;正常人的血浆中不含有或含有少量心脏型脂肪结合蛋白,在心肌受损后能快速释放。心脏型脂肪结合蛋白在体外循环冠状动脉搭桥后围手术期心肌损伤鉴别中具有良好的诊断价值;可以较早快速评价体外循环瓣膜置换术心肌损伤的潜在有用指标;脂肪酸结合蛋白的升高水平可较早的判断心肌损伤的程度,从而判断术后心功能受损的程度和与心脏有关的并发症。

Research progress of heart type fat binding protein and its application in cardiac surgery

BACKGROUND:Heart-type fatty-binding protein is one of the most abundant proteins in the cytoplasm of myocardial cells, which is a marker protein for myocardial injury.OBJECTIVE:To summarize the biology structure and function, metabolism dynamics of heart-type fatty binding protein, and their progress in clinical research and application in cardiac surgery.METHODS:A search of PubMed and VIP databases (1983-01/2010-12) was performed by the first author for the literature of the biological structure and function of heart-type fatty-binding proteins and their application in cardiac surgery as well as other clinical applications. The keywords were “creatine kinase isoenzyme, heart fatty acid-binding protein, acute myocardial infarction, coronary artery bypass grafting” in English and in Chinese, respectivley. Unrelated articles or repetitive articles were excluded, and finally 62 articles were included in result analysis.RESULTS AND CONCLUSION:Heart-type fatty-binding protein is a soluble protein with a low molecular weight, more specific in myocardial cytoplasm, and no or a little in normal plasma, which can quick release after myocardial damage. Heart-type fatty-binding protein has a good diagnostic value for perioperative myocardial injury after on-pump coronary artery bypass, and it is a potential indicator in the rapid assessment of myocardial injury induced by cardiopulmonary bypass valve replacement surgery as soon as possible. Elevated levels of heart-type fatty-binding proteins can be earlier to judge the severity of myocardial injury and to determine the degree of impaired cardiac function and heart-related complications.