心型脂肪酸结合蛋白和结合珠蛋白联合检测对急性冠脉综合征的诊断价值
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摘要
目的探讨心型脂肪酸结合蛋白(H-FABP)和结合珠蛋白(HP)联合检测对急性冠脉综合征(ACS)的诊断价值。方法纳入2014年2月~2016年1月收治的306例ACS患者和306例健康对照者,检测入院时和入院8h后(对照组除外)的血清H-FABP和HP浓度,采用t检验或卡方检验比较不同时刻H-FABP和HP的浓度和阳性率以及两指标的诊断灵敏度、特异度和准确性。结果早期ACS组(胸痛时间<6h)和中晚期ACS组(胸痛时间≥6h)的H-FABP浓度和阳性率以及HP阳性率均显著高于对照组(P<0.05),而三组间的HP浓度无显著差异(P>0.05);入院8h后,早期ACS组和中晚期ACS组的H-FABP浓度和阳性率显著降低(P<0.05),而HP浓度和阳性率显著升高(P<0.05);入院时的H-FABP和入院8h后的HP联合诊断ACS的灵敏度高达97.7%、特异度为100%、准确性为98.9%,显著高于单一指标的诊断效果(P<0.05)。结论早期HFABP和中期HP联合检测ACS的效果佳,值得临床推广应用。
Objective To detected the diagnosis value of heart-type fatty acid binding protein combined with haptoglobin for acute coronary syndrome. Methods Total 306 patients with ACS and 306 healthy controls treatment during February 2014 and January 2016 were included,then examined the serum H-FABP and HP concentration in the admission and admission 8 h later(except for the control group),finally,the t test or chi-square was used to analyze the concentration,positive rate,sensitivity,specificity,and accuracy of H-FABP and HP. Results When admission,The H-FABP concentration and positive rate as well as HP positive rate were significantly higher in the early ACS group(Chest pain time <6 h) and advanced ACS group(Chest pain time ≥6 h) than control group(P<0.05),while the HP concentration was no significant difference(P>0.05);after of admission,H-FABP concentrations and the positive rate of early ACS group and advanced ACS group was significantly reduced(P<0.05),and HP concentration and positive rate was significantly increased(P<0.05);H-FABP(in admission) combined with HP(admission 8 h later) for diagnosis of ACS has a sensitivity of 97.7%,specificity of 100%,and accuracy of 98.9%,which were significantly higher than the diagnosis of a single index(P<0.05). Conclusion Early H-FABP combined with middle term HP has a good effect on the detection of ACS,which was worthy for clinical application.
Objective To detected the diagnosis value of heart-type fatty acid binding protein combined with haptoglobin for acute coronary syndrome. Methods Total 306 patients with ACS and 306 healthy controls treatment during February 2014 and January 2016 were included,then examined the serum H-FABP and HP concentration in the admission and admission 8 h later(except for the control group),finally,the t test or chi-square was used to analyze the concentration,positive rate,sensitivity,specificity,and accuracy of H-FABP and HP. Results When admission,The H-FABP concentration and positive rate as well as HP positive rate were significantly higher in the early ACS group(Chest pain time <6 h) and advanced ACS group(Chest pain time ≥6 h) than control group(P<0.05),while the HP concentration was no significant difference(P>0.05);after of admission,H-FABP concentrations and the positive rate of early ACS group and advanced ACS group was significantly reduced(P<0.05),and HP concentration and positive rate was significantly increased(P<0.05);H-FABP(in admission) combined with HP(admission 8 h later) for diagnosis of ACS has a sensitivity of 97.7%,specificity of 100%,and accuracy of 98.9%,which were significantly higher than the diagnosis of a single index(P<0.05). Conclusion Early H-FABP combined with middle term HP has a good effect on the detection of ACS,which was worthy for clinical application.
引文
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[14]赵晓玲.心型脂肪酸结合蛋白检测对早期急性冠状动脉综合征诊断的价值[J].检验医学与临床,2015,12(8):1059-1060.
[15]李萍,王化芬,许会彬,等.心肌型脂肪酸结合蛋白和肌钙蛋白T联合检测对诊断急性冠脉综合征的意义[J].国际检验医学杂志,2013,34(22):3007-3008.
[16]劳绮云,沈彦燊,何钟梁,等.血清结合珠蛋白在急性心肌梗塞病者中的动态变化观察(摘要)[J].广东医学,1990,11(2):29.
[17]赵琛,王航,肖芝秀.急性心肌梗死患者血浆结合珠蛋白的变化及其意义[J].中国动脉硬化杂志,2015,23(8):837-839.
[2]周青松,童金英,潘荣华,等.急性冠脉综合征患者缺血性J波与心脏事件关系的研究[J].江西医药,2010,45(6):520-521
[3]M?ckel M,Searle J,Hamm C,et al.Early discharge using single cardiac troponin and copeptin testing in patients with suspected acute coronary syndrome(ACS):a randomized,controlled clinical process study[J].European Heart J,2015,36(6):369-376.
[4]Mueller M,Biener M,Vafaie M,et al.Absolute and relative kinetic changes of high-sensitivity cardiac troponin T in acute coronary syndrome and in patients with increased troponin in the absence of acute coronary syndrome[J].Clinical Chemistry,2012,58(1):209-218.
[5]O’Donoghue M,de Lemos JA,Morrow DA,et al.Prognostic utility of heart-type fatty acid binding protein in patients with acute coronary syndromes[J].Circulation,2006,114(6):550-557.
[6]FJ ZHOU,CY ZHOU,YJ TIAN,et al.Diagnostic value of analysis of H-FABP,NT-pro BNP,and c Tn I in heart function in children withcongenital heart disease and pneumonia[J].European Review for Medical and Pharmacological Sciences,2014,18:1513-1516.
[7]Slunga L,Johnson O,Dahlen GH,et al.Lipoprotein(a)and acutephase proteins in acute myocardial infarction[J].Scandinavian J Clinical and Laboratory Investigation,1992,52(2):95-101.
[8]Leah E.Cahill,PHD*,Andrew P.Levy,MD,PHD,et al.Haptoglob￣in Genotype Is a Consistent Marker of Coronary Heart Disease Risk Among Individuals With Elevated Glycosylated Hemoglobin[J].NIH Public Access Author Manuscript,2013,19;61(7):728-737.
[9]梁晓芳,何国平.心脏型脂肪酸结合蛋白(H-FABP)在早期诊断急性心肌梗死中的价值[J].2012,25(3):94-96.
[10]Slot MHEB,Rutten FH,Van der Heijden G,et al.Diagnostic value of a heart-type fatty acid-binding protein(H-FABP)bedside test in suspected acute coronary syndrome in primary care[J].International J Cardiology,2013,168(2):1485-1489.
[11]Lipiski M,Deuel JW,Baek JH,Engelsberger WR,Buehler PW,Schaer DJ.Human Hp1-1 and Hp2-2 phenotype-specific haptoglobin therapeutics are both effective in vitro and in guinea pigs to attenuate hemoglobin toxicity.Antioxid Redox Signal2013;19:1619-1633.
[12]刘华伟,杨清,何春容,等.心型脂肪酸结合蛋白对急性冠脉综合征患者的诊断价值及预后评估的研究[J].标记免疫分析与临床,2013,20(6):381-384.
[13]Kilcullen N,Viswanathan K,Das R,et al.Heart-type fatty acidbinding protein predicts long-term mortality after acute coronary syndrome and identifies high-risk patients across the range of troponin values[J].J American College of Cardiology,2007,50(21):2061-2067.
[14]赵晓玲.心型脂肪酸结合蛋白检测对早期急性冠状动脉综合征诊断的价值[J].检验医学与临床,2015,12(8):1059-1060.
[15]李萍,王化芬,许会彬,等.心肌型脂肪酸结合蛋白和肌钙蛋白T联合检测对诊断急性冠脉综合征的意义[J].国际检验医学杂志,2013,34(22):3007-3008.
[16]劳绮云,沈彦燊,何钟梁,等.血清结合珠蛋白在急性心肌梗塞病者中的动态变化观察(摘要)[J].广东医学,1990,11(2):29.
[17]赵琛,王航,肖芝秀.急性心肌梗死患者血浆结合珠蛋白的变化及其意义[J].中国动脉硬化杂志,2015,23(8):837-839.