摘要
目的探讨心肌型脂肪酸结合蛋白(H-FABP)在病人出现急性胸痛症状早期区分诊断急性冠脉综合征(ACS)患者与正常人的效果。方法人为纳入正常人、急性心肌梗死(AMI)确诊病人比例2∶1以及正常人、不稳定心绞痛(UAP)确诊病人比例2∶1的小样本人群。采用双抗体夹心ELISA法对40例正常人、19例AMI患者以及20例UAP患者血清H-FABP浓度进行定量。分别绘制H-FABP在正常人、AMI患者组成的人群以及正常人、UAP患者组成的人群中用于诊断AMI和UAP者的特征曲线(ROC曲线)并比较曲线下面积(AUC)与0.5的大小,0.5被认为是确定一项指标是否具有任何诊断意义的AUC临界值。结果H-FABP浓度定量正常人组为(1.29±0.64)ng/ml、AMI组为(24.45±32.40)ng/ml、UAP组为(1.95±3.11)ng/ml,依此绘制出的ROC曲线其AUC分别为AUCAMI:0.978(95%CI:0.948￣1.000),AUCUAP:0.503(95%CI:0.334￣0.671)。前者与0.5相比具有显著差异而后者没有。结论H-FABP具备在急性胸痛症状出现早期区分AMI与正常人的能力,但不具备早期区分UAP与正常人的能力。H-FABP定量检测可用于AMI早期诊断。
Objective To estimate the reliability of heart-type fatty acid-binding protein （H-FABP） for identifying acute coronary syndrome （ACS） in the early stage of chest pain onset. Methods This investigation was conducted based on a small population consisting of 40 healthy individuals, 19 established AMI patients and 20 unstable angina pectoris （UAP） patients. Serum H-FABP concentrations were measured in these subjects by sandwich ELISA, and receiver operating characteristics （ROC） curves for H-FABP for diagnosing AMI and UAP against normal subjects were then generated respectively. The areas under curve （AUCs） were calculated, and 0.5 was defined as the critical value of AUC to evaluate the diagnostic ability. Resuits The concentrations of H-FABP in healthy individuals, AMI patients and UAP patients were 1.29±0.64, 24.45±32.40 and 1.95±3.11 ng/ml, respectively; AUC AMI and AUC UAP were 0.978 （95 %CI ：0.948-1.000） and 0.503 （95 %CI ：0.334-0.671） respectively, and the former was significantly greater than 0.5. Conclusions In the early stage of chest pain onset H-FABP detection is sufficient in distinguishing AMI patients from healthy individuals, but not capable of distinguishing UAP patients from healthy individuals. H-FABP may bc used as a diagnostic biochemical marker in the early stage of AMI.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2006年第3期358-360,共3页
Journal of Southern Medical University
关键词
脂肪酸类
心肌梗死
不稳定心绞痛
生化标志物
fatty acids
myocardial infarction
unstable angina pectoris
biochemical marker
