【摘要】 目的研究血清心肌型脂肪酸结合蛋白(H-FABP)在早期急性心肌梗死(AMI)诊断中的价值。方法选择82例疑似急性心肌梗死的胸痛患者,采用快速检测法检测患者发病0~3h、3~6h和6h后血清的H-FABP,并与心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)的检测结果进行比较,分析3种心肌标志物在诊断不同发病时间段AMI的敏感性和特异性。结果H-FABP检测诊断AMI的敏感性在0~3h(66.7%)和3~6h(100%)时间段显著高于cTnI(33.3%、66.7%)和CK-MB(0%、61%);在诊断特异性上,H-FABP高于cTnI,比CK-MB低;H-FABP诊断AMI的准确率高达94.15%。结论H-FABP对于诊断早期AMI具有较高的敏感性和良好的特异性,更适合于临床AMI的早期诊断。更多还原

【Abstract】 Objective To compare the diagnostic efficacy of a newly developed whole blood rapid panel test for heart-type fatty acid binding protein (H-FABP) with that of cardiac troponin I (cTnI) and creatine kinase isoenzyme MB (CK-MB). Methods Eighty-two patients with suspected acute myocardial infarction (AMI) according to certain time frames from onset to presentation. The rapid panel test method was applied to detect the H-FABP and cTnI. The serum CK-MB activity was determined with an immuno-inhibition assay kit. The sensitivity and specificity in diagnosis of early AMI were analyzed between H-FABP and cTnI and CK-MB. Results Final diagnosis was confirmed within 42 patients who were suspected AMI. The overall sensitivities of H-FABP, cTnI and CK-MB were 85.7%, 76.2% and 31.7%, respectively. The relative sensitivities of these 3 markers were 66.7%, 100% and 0% for AMI patients presented within 3h of onset of symptom; 100%, 67% and 67% for those between 3 and 6h. While the relative specificities of these 3 markers were 100%, 50% and 100% within 3h of onset, and 94%, 75% and 100% for those between 3h and 6h. Negative predictive values were 100%, 67% and 84% for patients within 6h of onset. Conclusions H-FABP is more sensitive and specific in diagnosis of early AMI, which may has great potential as an excellent biochemical cardiac marker for diagnosis of AMI in the early phase.更多还原