摘要
目的探讨心型脂肪酸结合蛋白（H-FABP）和缺血性修饰蛋白（IMA）在急性心肌梗死（AMI）早期诊断及严重程度评估中的临床意义。方法选择因急性胸痛6 h内入院、并最终明确诊断的患者92例,其中AMI患者54例,不稳定型心绞痛（UAP）患者21例,稳定型心绞痛（SAP）患者17例,收集同期健康体检人群20例作为对照。于入院第一时间采集静脉血检测肌酸激酶同工酶MB（CK-MB）、肌钙蛋白T（c Tn T）、H-FABP及IMA。测定结果经受试者工作曲线（ROC曲线）分析获得区分AMI与非AMI的最适界值点（Cut-off）值。结果 AMI组血清H-FABP和IMA高于UAP组、SAP组和对照组,UAP组、SAP组血清H-FABP和IMA又高于对照组,差异具有统计学意义（P〈0.05）。H-FABP和IMA的ROC曲线下面积分别为0.967和0.904,诊断AMI的敏感性分别为92.6%和96.3%,显著高于c Tn T的83.3%和CK-MB的79.6%。H-FABP和IMA血清水平在Gensini积分≥40积分组明显高于20~40积分组和0~20积分组（P〈0.05）,H-FABP和IMA血清水平在冠状动脉三支病变组显著高于双支病变组和单支病变组（P〈0.05）。结论 H-FABP和IMA在AMI的早期诊断中敏感性和特异性较高,且与AMI患者冠状动脉病变严重程度有关;H-FABP和IMA在AMI的早期诊断、严重程度的判断等方面具有重要的意义。
Aim To investigate serum heart-type fatty acid-binding protein（ H-FABP） and ischemia modified albumin（ IMA） in early diagnosis and severity judgement in patients with acute myocardial infarction（ AMI）. Methods 92 patients admission into hospital with acute chest pain in 6 hours were selected as the patient group,and they were verified by coronary angiography. The patients were divided into AMI group（ 54 patients）,unstable angina pectoris（ UAP） group（ 21 patients） and stable angina pectoris（ SAP） group（ 17 patients）. At the same time,20 healthy people were selected as health control group. Blood samples of the patients and the control group were collected for test of CKMB,cT nT,IMA and H-FABP. The results of ROC curve analysis was used to determine the optimal cut-off of this assay for identifying individuals with AMI and non-AMI. Results The levels of H-FABP and IMA in AMI patients were significantly higher than those in the other three group; the levels of H-FABP and IMA in UAP group and SAP group were higher than those in the control group（ P 〈 0. 05）. ROC curve of H-FABP and IMA showed the area under ROC curve was 0. 967 and 0. 904,the sensitivity in AMI diagnosis was 92. 6% and 96. 3%,they were significantly higher than cT nT（ 83. 3%） and CK-MB（ 79. 6%）. H-FABP and IMA serum levels in Gensini scores≥40 was significantly higher than those in 20 ~ 40 scores group and 0 ~ 20 scores group（ P 〈 0. 05）. H-FABP and IMA serum levels in three-branch group had significance difference than those in double-branch group and single-branch group（ P 〈 0. 05）. Conclusions Serum levels of H-FABP and IMA had higher sensitivity and specificity in AMI diagnosis and it was related to the severity ofcoronary artery disease. Serum H-FABP and IMA and the other biochemistry markers simultaneously was very useful to the early diagnosis,sensitivity judgement of the ACS.
出处
《中国动脉硬化杂志》
CAS
CSCD
北大核心
2014年第11期1137-1141,共5页
Chinese Journal of Arteriosclerosis
关键词
急性心肌梗死
心型脂肪酸结合蛋白
缺血性修饰蛋白
Acute Myocardial Infarction
Heart-type Fatty Acid-binding Protein
Ischemia Modified Albumin
