快速检测心肌脂肪酸结合蛋白诊断早期急性心肌梗死

目的 探讨快速检测血浆心肌脂肪酸结合蛋白（H-FABP）在诊断早期急性心肌梗死（AMI）中的价值.方法 比较H-FABP、cTnI、CK-MB和MYO四种物质定量检测诊断发病6 h内AMI的敏感性、特异性和准确性;比较H-FABP快速检测试剂条定性检测结果与ELISA定量检测结果.结果 H-FABP诊断发病3 h和6 h内AMI的敏感性显著高于cTnI和CK-MB,特异性相比,差异无显著性,诊断准确性显著高于cTnI、CK-MB和MYO.试剂条定性检测结果与ELISA比较符合率达96.9%.结论 H-FABP定性检测试剂条可用于早期AMI筛选诊断.

Heart-type fatty acid-binding protein in the diagnosis of acute myocardial infarction at early stage

Objective To evaluate the value of heart-type fatty acid-binding protein(H-FABP)in the diagnosis of acute myocardial infarction(AMI)at early stage.Methods The plasma level of H-FABP was measured by sandwich ELISA in 93 patients with suspected AMI at admission within 6 hours after onset of chest pain and 69 normal healthy subjects.The plasma concentrations of cardiac troponin-I(cTnI),creatine kinase-MB(CK-MB)and myoglobin(MYO)were determined at the same time by using corpuscle chemiluminescence.The diagnostic validity was evaluated in terms of sensitivity,specificity and receiver operating characteristic(ROC)curve analysis.The rapid one-step immunochromatography assay for H-FABP was constructed and the reliability was evaluated by the test of sensitivity,stability and the comparison with the sandwich-ELISA.Results The diagnostic sensitivity of H-FABP for AMI was 64.29% within 3 hours and 84.38 % within 6 hours after onset of chest pain,significantly higher than that of cTnI(28.57%,53.13%)and CK-MB(21.43%,56.25%).There was no significant difference in specificity among the four markers.The area under the ROC curve of H-FABP(0.979,0.958)within 3 hours and 6 hours was significantly larger than that of cTnI(0.800,0.878),CK-MB(0.575,0.782)and MYO(0.796,0.882).Conclusion H-FABP seems to be a useful biochemical cardiac marker for AMI at the early stage.