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学科主题: 急诊医学
题名:
心肌型脂肪酸结合蛋白与cTnT、CK-MB组合诊断早期急性冠脉综合征的比较
其他题名: Comparison of human heart-type fatty acid-binding protein used as an early diagnostic cardiac marker of acute coronary syndrome with combination of cardiac troponin-T and creatine kinasemyocardial band
作者: 李硕; 马青变; 郑亚安
关键词: 急性冠脉综合征 ; 心肌型脂肪酸结合蛋白 ; 心脏标志物 ; 诊断价值 ; Acute coronary syndromes ; Human heart-type fatty acid-binding protein ; Cardiac markers ; Diagnostic value
刊名: 中华急诊医学杂志
发表日期: 2012
DOI: 10.3760/cma.j.issn.1671-0282.2012.03.019
卷: 21, 期:3, 页:299-303
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 研究心肌型脂肪酸结合蛋白(H-FABP)对早期急性冠脉综合征(ACS)的诊断价值,比较不同心脏标志物联合检测诊断ACS的价值.方法 选择2010年4月至2011年6月因胸痛发作6h内就诊于北京大学第三医院急诊科的疑似ACS患者103例,就诊即刻采肘静脉血5ml.采用快速检测试剂盒(胶体金法)检测H-FABP,同时测定肌钙蛋白T(cTnT)和肌酸激酶同工酶MB (CK-MB).采用SPSS 17.0软件比较3种心脏标志物及不同心脏标志物组合在诊断急性心肌梗死(AMI)的灵敏度、特异度、阳性预测值和阴性预测值以及不同时间段诊断AMI的灵敏度和特异度.结果 在ACS发病6h内,H-FABP对AMI的诊断灵敏度(62.5%)高于cTnT(30.6%)和CK-MB (33.3%),差异具有统计学意义(P<0.01),特异度和阳性预测值差异无统计学意义.H-FABP+ cTnT组合的阴性预测值最高(53.8%).H-FABP在AMI发病3~6h的灵敏度(77.8%)高于发病0~3 h(53.3%),差异具有统计学意义(P=0.038).在AMI发病0~3h,H-FABP+ cTnT组合和H-FABP+ CK-MB组合的诊断灵敏度(55.6%)高于cTnT+ CK-MB组合(24.4%),差异具有统计学意义(P =0.003).在发病0~3h和3~6h,H-FABP+ cTnT组合诊断灵敏度高于单一检测H-FABP(分别提高3.3%和7.4%),H-FABP+ cTnT组合的诊断灵敏度在发病3~6h最高(85.2%).结论 H-FABP是目前早期(0~6 h)诊断ACS最敏感的心脏生化标志物,尤以发病3~6 h更为敏感.H-FABP+ cTnT组合比单一检测H-FABP的诊断灵敏度高,发病3~6h的H-FABP+ cTnT组合具有最好的诊断价值. Objective To evaluate the early diagnostic value of human heart-type fatty acid- binding protein (H-FABP) of acute coronary syndrome (ACS) and compare the diagnostic accuracy of different combination regimens of cardiac markers. Methods A total of 103 consecutive patients with chest pain (within 6 h after admission to Peking University Third Hospital,emergency department) suggestive of ACS were recruited for the analysis from April,2010 to June,2011.The blood levels of H-FABP,cardiac troponin-T (cTnT) and creatine kinase-myocardial band (CK-MB) were obtained at admission. The sensitivity,specificity,positive predictive value and negative predictive value together with the sensitivity and specificity in different phases of illness at admission were analyzed and compared among H-FABP,cTnT,CK-MB and different combinations by using SPSS version 17.0 software.Results Within 6 h of onset of symptom,the overall sensitivities of H-FABP,cTnT and CK-MB were 62.5%,30.6% and 33.3% respectively for patients with ACS.The sensitivity of H-FABP was significantly higher than that of cTnT and CK-MB (P <0.01 ).There were no differences in specificity and positive predictive value.The combination of H-FABP with cTnT had the greatest negative predictive value (53.8% ).The sensitivity of H-FABP was higher during 3 - 6 h (77.8% ) than during 0 - 3 h (53.3 % ) after chest pain onset (P =0.038).Within 0 - 3 h of onset of AMI,the overall sensitivities of the combination of H-FABP with cTnT and H-FABP with CK-MB (55.6%) were significantly higher than the combinaton of cTnT with CK-MB ( 24.4% ) ( P =0.003 ).The sensitivity of the combination of H-FABP with cTnT was higher than that of single H-FABP during 0- 3 h and 3 -6 h after onset of AMI with increment in 3.3% and 7.4% respectively.The combination of H-FABP with cTnT had the greatest sensitivity ( 85.2% ) during 3 - 6 h after onset.Conclusions H-FABP is the most sensitive cardiac marker in diagnosing of ACS in the early phase within 6 h,especially during 3 -6 h after onset.The sensitivity of the combination of H-FABP with cTnT is higher than that of H-FABP alone.The combination of H-FABP with cTnT has the best diagnostic value during 3 -6 h after onset of ACS.
语种: 中文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/71468
Appears in Collections:北京大学第三临床医学院_急诊科_期刊论文

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作者单位: 北京大学第三医院急诊科,北京,100191

Recommended Citation:
李硕,马青变,郑亚安. 心肌型脂肪酸结合蛋白与cTnT、CK-MB组合诊断早期急性冠脉综合征的比较[J]. 中华急诊医学杂志,2012,21(3):299-303.
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