床旁快速检测心型脂肪酸结合蛋白在老年急性心肌梗死早期诊断中的价值

目的 采用床旁快速检测（POCT）心型脂肪酸结合蛋白（H-FABP）,探讨心型脂肪酸结合蛋白（H-FABP）、肌钙蛋白T（cTnT）、肌酸激酶同工酶（CK-MB）在急性心肌梗死患者（AMI）早期诊断中的价值.方法 选取因急性胸痛疑似ACS的老年患者,留取血浆并测定血浆H-FABP、cTnT、CK-MB值,根据发病时间分为0～6h、6～12 h和＞12 h组进行分析.结果 在AMI早期（0～6h）H-FABP诊断效率（0.913）高于cTnT（0.786）和CK-MB（0.742）,灵敏度和特异度也较高（78.62％、85.70％）,血浆H-FABP浓度高于不稳定心绞痛（UAP）组和对照组（P＜0.01）.结论 H-FABP在AMI发生的早期有较高的诊断效率、灵敏性和特异性,可以作为早期,特别是6h内诊断AMI的生化标记物.POCT快速检测试剂盒具有操作简便快捷,结果可靠等优点,适合在临床推广.

The value of heart-type fatty acid-binding protein in early diagnosis of acute myocardial infarction by using point of-care testing in elderly patients

Objective To evaluate the diagnostic efficacy and value of heart-type fatty acid-binding protein （H-FABP） in early acute myocardial infarction by using Point-Of-care testing （POCT）.Methods The H-FABP、cTnT and CK-MB levels were measured in the patients with acute chest pain and suspected ACS.The patients were divided into three groups （0～6 h group、6 ～ 12 h group and＞ 12 h group） according to the onset time.Results In the early AMI （0～6 h）,the diagnostic efficiency of H-FABP （0.913） washigher thancTnT （0.786） andCK-MB （0.742）.The sensitivity and specificity of H-FABP were also high （78.62 ％、85.70 ％）.The plasma concentrations of H-FABP in were significantly higher than those in the UAP group and in the control group （P＜0.01）.Conclusion H-FABP had high diagnostic efficiency,sensitivity and specificity in the early acute myocardial infarction,and it could be used as a biochemical marker for early diagnosis of AMI within 6 hours.POCT had advantages of easy operation and reliable results,and it was suitable for using in clinical practice.