心型脂肪酸结合蛋白和钙卫蛋白联合检测在ST段抬高型急性心肌梗死中的应用价值
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摘要
[目的]观察心型脂肪酸结合蛋白(H-FABP)和钙卫蛋白(S100A/B)联合检测在ST段抬高型急性心肌梗死(STEMI)中的诊断价值。[方法]纳入STEMI患者41例(病例组)和同期非心源性胸痛患者38例(对照组),以酶联免疫吸附实验(ELISA)试剂盒测定所有患者血清H-FABP与S100A/B含量,受试者工作特征曲线(ROC)曲线分析HFABP与S100A/B联合诊断STEMI的价值。[结果]病例组血清H-FABP与S100A/B含量明显高于对照组(P<0.05),病例组血清中H-FABP及S100A/B水平呈正相关(P<0.05)。单独以H-FABP、S100A/B及联合来诊断STEMI,敏感度分别是81.05%、76.08%和80.67%,特异度分别为70.25%、74.61%及89.27%,曲线下面积分别是0.81、0.77及0.89。[结论] H-FABP、S100A/B在STEMI患者血清中明显增高,并呈正相关性,联合检测有助于STEMI的诊断。
[Objective] To observe the value of combined measurement of heart-type fatty acid-binding protein(H-FABP) and calprotectin(S100 A/B) in diagnosis of ST segment elevation myocardial infarction(STEMI). [Methods] A total of 41 patients with STEMI(case group)and 38 patients with non-cardiogenic chest pain(control group) were collected as study individuals. ELISA kit was used to measure the levels of serum H-FABP and S100 A/B. The clinical value of combined measurement of H-FABP and S100 A/B in diagnosis of STEMI was assessed. [Results] The levels of serum H-FABP and S100 A/B in case group were significantly increased compared with control group(P<0.05). In the case group, serum H-FABP level was positively associated with S100 A/B level(P<0.05). In the diagnosis of STEMI, HFABP alone, S100 A/B alone, and H-FABP/S100 A/B combination had sensitivities of 81.05%, 76.08% and 80.67%, specificities of 70.25%, 74.61% and 89.27%, and areas under the ROC curves of 0.81, 0.77 and 0.89. [Conclusion] Patients with STEMI have significant increases in H-FABP and S100 A/B levels, and there is a correlation among them. Combined measurement of H-FABP and S100 A/B can increase the value of the diagnosis of STEMI.
[Objective] To observe the value of combined measurement of heart-type fatty acid-binding protein(H-FABP) and calprotectin(S100 A/B) in diagnosis of ST segment elevation myocardial infarction(STEMI). [Methods] A total of 41 patients with STEMI(case group)and 38 patients with non-cardiogenic chest pain(control group) were collected as study individuals. ELISA kit was used to measure the levels of serum H-FABP and S100 A/B. The clinical value of combined measurement of H-FABP and S100 A/B in diagnosis of STEMI was assessed. [Results] The levels of serum H-FABP and S100 A/B in case group were significantly increased compared with control group(P<0.05). In the case group, serum H-FABP level was positively associated with S100 A/B level(P<0.05). In the diagnosis of STEMI, HFABP alone, S100 A/B alone, and H-FABP/S100 A/B combination had sensitivities of 81.05%, 76.08% and 80.67%, specificities of 70.25%, 74.61% and 89.27%, and areas under the ROC curves of 0.81, 0.77 and 0.89. [Conclusion] Patients with STEMI have significant increases in H-FABP and S100 A/B levels, and there is a correlation among them. Combined measurement of H-FABP and S100 A/B can increase the value of the diagnosis of STEMI.
引文
[1]Shah AS,McAllister DA,Mills R,et al.Sensitive troponin assay and the classification of myocardial infarction[J].Am J Med,2015,128(5):493-501.
[2]Gupta T,Harikrishnan P,Kolte D,et al.Outcomes of acute myocardial infarction in patients with hypertrophic cardiomyopathy[J].Am J Med,2015,128(8):879-887
[3]Matsue Y,Yoshida K,Hoshino M,et al.Clinical features and prognosis of type 2 myocardial infarction in vasospastic angina[J].Am J Med,2015,128(4):389-395.
[4]Conde D,Lalor N,Rodriguez L,et al.B-type natriuretic peptide predicts complexity and severity of the coronary lesions in patients with ST-segment elevation myocardial infarction[J].Am J Emerg Med,2014,32(1):88-94.
[5]Shah AS,McAllister DA,Mills R,et al.Sensitive troponin assay and the classification of myocardial infarction[J].Am J Med,2015,128(5):493-501.
[6]Kaptoge S,Seshasai SR,Gao P,et al.Inflammatory cytokines and risk of coronary heart disease:new prospective study and updated meta-analysis[J].Eur Heart J,2014,35(9):578-589.
[7]袁平年.冠状动脉易损斑块相关炎性因子的研究进展[J].实用心脑肺血管病杂志,2012,20(2):363-366.
[8]Cai XY,Lu L,Wang YN,et al.Association ofincreased S100B,S100A6 and SLOOP in serum levels with acute coronary syndrome and also with the severity of myocardial infarction in cardiac tissue of rat models with ischemia-reperfusion injury[J].Atherosclerosis,2011,217(2):536-542.
[9]Nakata T,Hashimoto A,Hase M,et al.Human hearttype fatty acidbinding protein as an early diagnostic and prognostic marker in acute coronary syndrome[J].Cardiology,2003,99(2):96-104.
[10]中华医学会心血管病学分会,中华心血管病杂志编委会.ST段抬高心肌梗死和非ST段抬高心肌梗死诊断与治疗指南[J].中华心血管病杂志,2010,35(12):1076-1083.
[11]刘静宇,高学文.心型脂肪酸结合蛋白在急性冠脉综合征中的研究进展[J].内蒙古医学杂志,2012,44(3):329-332.
[12]Cotoi OS,Duner P,Ko N,et al.Plasma S100A8/A9 correlates with blood neutrophil counts,traditional risk factors,and cardiovascular disease in middle-Aged healthy individuals[J].Arterioscler Thromb Vasc Biol,2014,34(1):202-210.
[13]罗翊芝,谭晓晖,伍伟铭,等.联合检测心型脂肪酸结合蛋白和缺血修饰蛋白对急性非ST段抬高型心肌梗死患者的早期诊断意义[J].中国当代医药,2016,23(1):29-31.
[14]许名东,杨溶海,梁建光.联合检测血清S100A/B、H-FABP与ST段抬高型急性心肌梗死患者近期预后的相关性[J].实用医学杂志,2016,32(13):2217-2219.
[2]Gupta T,Harikrishnan P,Kolte D,et al.Outcomes of acute myocardial infarction in patients with hypertrophic cardiomyopathy[J].Am J Med,2015,128(8):879-887
[3]Matsue Y,Yoshida K,Hoshino M,et al.Clinical features and prognosis of type 2 myocardial infarction in vasospastic angina[J].Am J Med,2015,128(4):389-395.
[4]Conde D,Lalor N,Rodriguez L,et al.B-type natriuretic peptide predicts complexity and severity of the coronary lesions in patients with ST-segment elevation myocardial infarction[J].Am J Emerg Med,2014,32(1):88-94.
[5]Shah AS,McAllister DA,Mills R,et al.Sensitive troponin assay and the classification of myocardial infarction[J].Am J Med,2015,128(5):493-501.
[6]Kaptoge S,Seshasai SR,Gao P,et al.Inflammatory cytokines and risk of coronary heart disease:new prospective study and updated meta-analysis[J].Eur Heart J,2014,35(9):578-589.
[7]袁平年.冠状动脉易损斑块相关炎性因子的研究进展[J].实用心脑肺血管病杂志,2012,20(2):363-366.
[8]Cai XY,Lu L,Wang YN,et al.Association ofincreased S100B,S100A6 and SLOOP in serum levels with acute coronary syndrome and also with the severity of myocardial infarction in cardiac tissue of rat models with ischemia-reperfusion injury[J].Atherosclerosis,2011,217(2):536-542.
[9]Nakata T,Hashimoto A,Hase M,et al.Human hearttype fatty acidbinding protein as an early diagnostic and prognostic marker in acute coronary syndrome[J].Cardiology,2003,99(2):96-104.
[10]中华医学会心血管病学分会,中华心血管病杂志编委会.ST段抬高心肌梗死和非ST段抬高心肌梗死诊断与治疗指南[J].中华心血管病杂志,2010,35(12):1076-1083.
[11]刘静宇,高学文.心型脂肪酸结合蛋白在急性冠脉综合征中的研究进展[J].内蒙古医学杂志,2012,44(3):329-332.
[12]Cotoi OS,Duner P,Ko N,et al.Plasma S100A8/A9 correlates with blood neutrophil counts,traditional risk factors,and cardiovascular disease in middle-Aged healthy individuals[J].Arterioscler Thromb Vasc Biol,2014,34(1):202-210.
[13]罗翊芝,谭晓晖,伍伟铭,等.联合检测心型脂肪酸结合蛋白和缺血修饰蛋白对急性非ST段抬高型心肌梗死患者的早期诊断意义[J].中国当代医药,2016,23(1):29-31.
[14]许名东,杨溶海,梁建光.联合检测血清S100A/B、H-FABP与ST段抬高型急性心肌梗死患者近期预后的相关性[J].实用医学杂志,2016,32(13):2217-2219.