摘要
目的探讨急性冠脉综合征(ACS)患者血浆心型脂肪酸结合蛋白(H-FABP)水平变化及其临床意义。方法冠心病患者110例行冠状动脉造影证实,其中急性心肌梗死(AMI)35例、不稳定型心绞痛(UAP)45例,稳定型心绞痛30例。健康对照者30例。采用双抗体夹心ELISA法检测血浆H-FABP、肌红蛋白(MYO)、肌钙蛋白(cTnI)和肌酸激酶同工酶(CK-MB)水平,根据美国心脏病协会所规定的冠状动脉血管图像记分分段评价标准,对血管病变狭窄程度进行分度,计算病变血管支数;比较各组血浆H-FABP、MYO和cTnI、CK-MB水平与冠状动脉狭窄程度、病变支数的关系。结果 4组受检者血浆H-FABP、MYO、CK-MB、cTnI水平比较,差异均有统计学意义(P<0.01),其中UAP组、AMI组患者H-FABP与SAP组比较,差异有统计学意义(P<0.01)。ACS患者胸痛出现时间无论是<3 h,还是≥3 h,其血浆H-FABP、MYO、cTnI及CK-MB的阳性率比较,差异均有统计学意义(P<0.01)。ACS冠状动脉1支、2支、多支病变患者血浆H-FABP水平比较,差异有统计学意义(P<0.05)。ACS冠状动脉轻度、中度、重度病变患者血浆H-FABP水平比较,差异有统计学意义(P<0.05)。ACS患者中46例心脏射血分数(EF)≥40%,34例EF<40%,其血浆H-FABP水平比较差异有统计学意义(P<0.05)。结论 H-FABP对ACS的诊断较MYO、CK-MB和cTnI更敏感。H-FABP水平与ACS患者冠状动脉病变严重程度有关。ACS患者血浆H-FABP、MYO、cTnI以及CK-MB水平均升高。
Objective To explore the changes of heart-type fatty acid binding protein（H-FABP） in patients with acute coronary syndrome（ACS） and its clinical significance.Methods 110 patients suffered from coronary heart disease including 35 cases of acute myocardial infarction（AMI）,45 cases of unstable angina pectoris（UAP） and 30 cases stable angina pectoris（SAP） were verified by coronary angiography,while 30 healthy cases were taken as control group.Plasma concentration of H-FABP,myoglobin（MYO）,cardiac troponin I（cTnI） and creatine kinase isoenzyme MB（CK-MB） were measured by Double-antibody sandwich ELISA quantitative analysis.According to the coronary blood vessels under the subimage points of evaluation criteria by American Heart Association,the degree of stenosis were indexed,and the involving vessel count were calculated.The relationship of blood H-FABP,MYO,CK-MB and cTnI with coronary artery stenosis and lesion count were compared.Results The difference of plasma H-FABP,MYO,CK-MB and cTnI levels was statistically significant（P 0.01） in 4 groups,among which the difference of H-FABP in patients with UAP and those with SAP was statistically significant（P 0.01）.The difference of plasma H-FABP,MYO,cTnI and CK-MB positive rate was statistically significant（P 0.01） between ACS patients with chest pain below 3 hours,or above and equal to 3 hours.The difference of plasma H-FABP levels was statistically significant（P 0.05） among 1 branch,2 branch and multi-branch lesion vessel with ACS coronary artery disease.Among coronary artery with mild,moderate and severe lesions in ACS patients,the difference of plasma H-FABP levels was statistically significant（P 0.05）.In ACS patients,there were 46 cases with EF≥40%,compared with 34 cases with EF 40%,the level of plasma H-FABP was significantly different（P 0.05）.Conclusion H-FABP is more sensitive for the diagnosis of ACS than MYO,cTnI and CK-MB.The level of H-FABP in patients with ACS is related to the severity of coronary artery disease.Plasma levels of H-FABP,MYO,cTnI and CK-MB will increase in patients with acute coronary syndrome.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第33期3731-3734,共4页
Chinese General Practice
基金
江西省卫生厅科技计划项目资助(20051005)
作者简介
通讯作者：陈章强，330006江西省南昌市，江西省人民医院心血管内科；E-mail：chenzq888@163．com
