慢性心力衰竭患儿心型脂肪酸结合蛋白的变化及临床意义

目的：通过前瞻性观察慢性心力衰竭（CHF）患儿血浆心型脂肪酸结合蛋白（h-FABP）的水平变化及其与心功能的关系，探讨其在CHF中的临床价值。方法：36例CHF患儿（CHF组）纳入研究，其中心内膜弹力纤维增生症16例（EFE组），扩张型心肌病20例（DCM组）。选择同期30例健康儿童作为对照组。血浆h-FABP浓度测定采用酶联免疫吸附法（ELISA），并以心脏超声心动图测量心脏指数、左室短轴缩短率及左室射血分数。结果：CHF患儿血浆h-FABP浓度明显高于对照组（21.7±4.3 ng/mL vs 6.2±1.7 ng/mL, P＜0.01），且心力衰竭程度越重，h-FABP浓度升高越明显（P＜0.01）。EFE、DCM两组h FABP水平均高于对照组（P＜0.01）。CHF患儿h-FABP水平与左室射血分数、心脏指数及左室短轴缩短率均呈明显负相关（分别r=-0.65、-0.64、-0.71，均P＜0.01）。结论：CHF患儿的血浆h-FABP浓度明显升高，血浆h FABP浓度与心力衰竭的严重程度相关。血浆h-FABP浓度可作为评估心力衰竭及其严重程度的一个指标。

Changes of heart--type fatty acid-binding protein in children with chronic heart failure and its significance

Objective To study serum levels of heart-type fatty acid-binding protein(h-FABP) in children with chronic heart failure(CHF),and the correlation between heart function and the level of h-FABP,with the aim of studying the significance of h-FABP in CHF.Methods Thirty-six children with CHF,including 16 cases of endocardial fibroelastosis(EFE) and 20 cases of dilated cardiomyopathy(DCM) were enrolled in the study.Thirty healthy children sevred as the control group.Serum levels of h-FABP were determined using ELISA,and left ventricular ejection fraction(LVEF),cardiac index(CI) and fractional shortening of the left ventricle(LVSF) were measured by two-dimensional echocardiography in the CHF group.Results Mean levels of h-FABP in the CHF group were significantly higher than in the control group(21.7±4.3 ng/mL vs 6.2±1.7 ng/mL;P<0.01).The worse the heart function,the higher the h-FABP levels(P<0.01).Mean levels of h-FABP in both the EFE and DCM groups were significantly higher than in the control group(P<0.01).Serum h-FABP concentrations were negatively correlated with LVEF,CI and LVSF(r=-0.65,-0.64 and-0.71 respectively;P<0.01) in the CHF group.Conclusions Serum h-FABP levels increase in children with CHF and are closely related to the severity of the condition.Serum h-FABP levels can be used as a biomarker for the diagnosis of heart failure and the evaluation of its severity.