南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (09): 1347-.

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三种心肌损伤标志物对早期急性心肌梗死的诊断价值

王亚蓉，郭壮波，黄丽萍   

  • 出版日期:2014-09-20 发布日期:2014-09-20

Value of different biochemical markers in early diagnosis of acute myocardial infarction

  • Online:2014-09-20 Published:2014-09-20

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摘要： 目的研究不同心肌损伤标志物如肌酸激酶同工酶（CK-MB）、心肌钙蛋白T（cTnT）及心型脂肪酸结合蛋白（H-FABP）对
早期急性心肌梗死（AMI）的诊断价值。方法入选胸痛疑似急性心肌梗死患者138例，确诊为AMI组95例，非AMI组43例，检
测两组患者发病<3 h、3~6 h及6~12 h的血清CK-MB、c TNT和H-FABP水平，并比较2组CK-MB、c TNT和H-FABP不同时间
血清水平；比较CK-MB、c TNT和H-FABP在AMI发病<3 h、3~6 h及6~12 h诊断AMI的敏感性及特异性。结果AMI组血清
H-FABP在AMI后<3 h即明显升高（P<0.01），3~6 h及6~12 h进一步升高（P<0.001）；血清cTnT在发病3 h内无明显升高，3~6 h
轻度升高（P<0.05），6~12 h水平显著升高（P<0.01）；CK-MB在发病3 h内及3~6 h均无明显升高，发病6~12 h水平显著升高（P<
0.05）。AMI发病<3 h、3~6 h 血清H-FABP诊断的敏感性及特异性高于CK-MB、c TNT（P<0.05），发病6~12 h血清H-FABP诊断
的敏感性及特异性与cTnT无显著差异（P>0.05），但高于CK-MB（P<0.05）。结论AMI患者检测血清心肌损伤标志物H-FABP
对AMI早期<3 h及3~6 h）诊断价值优于传统心肌标志物。

Abstract: Objective To study the value of the biochemical markers heart fatty acid binding protein (H-FABP), creatine kinase
isoenzyme-MB (CK-MB), myocardial troponin T (cTnT) in early diagnosis of acute myocardial infarction (AMI). Methods
Serum levels of H-FABP, CK-MB, and cTNT were detected in 95 patients with confirmed AMI at different time points
following the onset in comparison with the data from 43 patients without AMI. The sensitivity and specificity of H-FABP in
different phases following the onset were compared between those of CK-MB and cTnT. Results Serum H-FABP activities
increased significantly within 3 h after the onset of AMI (P<0.01) and continued to increase at 3-6 h and 6-12 h (P<0.001). Serum
level of CK-MB within 6 h and cTnT level within 3 h after AMI onset did not show obvious changes (P<0.05). Both the
diagnostic sensitivity and specificity of H-FABP within 3 h and within 3-6 h were higher than those CK-MB and cTnT (P<0.05).
Conclusion H-FABP is superior to CK-MB and cTnT in early diagnosis (within 3 h and 3-6 h following the onset) of AMI.