摘要
目的分析血清心脏型脂肪酸结合蛋白(heart-type fatty acid-binding protein,H-FABP)动态变化对评估急性冠状动脉综合征(acute coronary syndrome,ACS)患者短期预后结局的预测价值。方法选择海南医学院第二附属医院就诊的77例ACS患者作为研究对象,按严重程度分为两组:不稳定型心绞痛组共31例,罹患不稳定型心绞痛;急性心肌梗死组共46例,罹患非ST段抬高型心肌梗死及ST段抬高型心肌梗死。于入院即刻、6 h、24 h、48 h分别检测并比较两组的血清H-FABP、心肌肌钙蛋白(cardiac troponin,cTn)I、肌酸激酶同工酶MB(creatine kinase isoenzyme MB,CK-MB)浓度的差异。随访6个月,依据患者发生主要心血管事件(majoradverse cardiovascular events,MACE)情况分为事件组和非事件组,比较两组上述指标的差异。应用多元Logistic回归分析上述指标与MACE发生率的相关性。结果两组H-FABP浓度随时间变化而改变,6 h达到峰值,后逐渐下降(P<0.05);而急性心肌梗死组cTnI与CK-MB浓度于24 h最高(P<0.05),但不稳定型心绞痛组cTnI与CK-MB浓度无显著性变化(P>0.05)。随访6个月,事件组ACS患者H-FABP浓度峰值延迟至24 h(P<0.05),且均高于非事件组(P<0.05),而两组cTnI与CK-MB峰值时间及浓度比较,差异无统计学意义(P>0.05)。血清H-FABP浓度与MACE发生率有正相关性(β=1.139,P=0.038)。结论血清H-FABP浓度动态变化能早期诊断ACS,其峰值时间延迟对短期预后判断有较高价值。
Objectives To analyze the clinical value of the dynamic variety of heart-type fatty acid-binding protein(H-FABP)monitoring on the short-term prognosis of patients with acute coronary syndrome(ACS).Methods Totally77patients diagnosed as ACS in The Second Affiliated Hospital of Hainan Medical College were collected and divided into two groups according to the severity of ACS:unstable angina pectoris(UAP)group(31cases,diagnosis of UAP)and acute myocardial infarction(AMI)group(46cases,diagnosis of non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction).Concentrations of H-FABP,cardiac troponin(cTn)I and creatine kinase isoenzyme MB(CK-MB)were detected and compared between the two groups at immediate admission,6h,24h and48h,respectively.After following up for6months,all the patients were divided into two groups according to the occurrence of major adverse cardiovascular events(MACE),which were MACE group and non-MACE group.The above indexes were also compared between MACE group and non-MACE group.Relationships of the above indexes and occurrence of MACE were analyzed by multivariate Logistic regression analysis.Results Concentrations of HFABP in the two groups changed over treatment duration,and the peak value reaching duration was6h,then concen?tration of H-FABP decreased gradually(P<0.05).Concentrations of cTnI and CK-MB in AMI group were highest at24h(P<0.05),but the concentrations of cTnI and CK-MB in UAP group were not various(P>0.05).After following up for6months,peak value reaching duration of H-FABP in MACE group were delayed to24h(P<0.05),and is higher than that in non-MACE group(P<0.05),but peak value reaching durations and concentrations of cTnI and CK-MB between the two groups had no obviously differences(β=1.139,P>0.05).Serum concentrations of H-FABP had a posi?tive relationship with occurrence of MACE(P=0.038).Conclusions Dynamic variety of H-FABP can early diagnose ACS and the delayed peak value reaching duration of H-FABP can predict short-term prognosis in patie
作者
白敏
王超
吴曾繁
陈向红
舒悦
陈磊
BAI Min;WANG Chao;WU Zeng-fan;CHEN Xiang-hong;SHU Yue;CHEN Lei(Department of Cardiology,The Second Affiliated Hospital of Hainan Medical College,Haikou 570311,China)
出处
《岭南心血管病杂志》
2017年第6期669-672,707,共5页
South China Journal of Cardiovascular Diseases
关键词
冠状动脉疾病
心脏型脂肪酸结合蛋白
主要心血管事件
预后
coronary artery disease
heart-type fatty acid-binding protein
major adverse cardiovascular events
prognosis
