心脏型脂肪酸结合蛋白定性检测对急性心肌梗死早期诊断的价值

目的:探讨心脏型脂肪酸结合蛋白(H-FABP)在急性心肌梗死(AMI)早期诊断中的价值。方法:运用胶体金免疫层析技术定性检测104例发病3h内胸痛患者的血H-FABP,比较其与心肌肌钙蛋白(cTnI)、肌酸激酶同功酶MB(CK-MB)、肌红蛋白(MYO)诊断早期AMI的敏感度、特异度。结果:入选患者中最终确诊为AMI患者50例,非AMI54例。H-FABP、cTnI、CK-MB和MYO检出AMI的敏感度分别为88.00%、68.00%、64.00%和84.00%,H-FABP显著高于cTnI和CK-MB(均P<0.05),与MYO比较无显著差异(P>0.05);检测特异度分别为90.74%、87.04%、85.19%和70.37%,H-FABP显著高于MYO(P<0.05),分别与cTnI和CK-MB比较均无显著差异(均P>0.05)。在四种心肌损伤标志物中,H-FABP的准确诊断指数最高。结论:H-FABP用于AMI早期诊断具有快速、简便,灵敏度和特异度高的特点,值得临床推广应用。

The value of heart-type fatty acid binding protein qualitative detection for diagnosis of early acute myocardial infarction

Objective To evaluate the efficacy of blood H-FABP in the diagnosis of early AMI.Methods We selected 104 patients with suspected AMI at admission within 3 hours after onset of chest pain,The blood HFABP was assayed by the gold immunochromatography,then compared with blood cTnI,CK-MB and MYO in sensitivity,specificity.Results Among the 104 recruited patients,50 cases had a find diagnosis of AMI,and 54 cases were excluded.The results displayed the sensitivity of H-FABP,cTnI,CK-MB and MYO in diagnosis of AMI were 88.00%、68.00%、64.00% and 84.00% respectively,and the specificity were 90.74%、87.04%、85.19% and 70.37% respectively.In sensitivity,H-FABP was significantly higher than cTnI and CK-MB(P < 0.05 for all),but there was no significant difference from MYO(P > 0.05).in specificity,H-FABP was significantly higher MYO(P < 0.05),while no significant difference from cTnI or CK-MB(P > 0.05 for all).In four kinds of myocardial injury markers,H-FABP has the highest accurate diagnosis index.Conclusion H-FABP has feasibility in early diagnose of AMI,qualitative detection of H-FABP was rapid,simple,high sensitivity and specificity,and deserves to be applied broadly.