2020 年第 4 期 第 15 卷

心型脂肪酸结合蛋白和红细胞体积分布宽度及心肌肌钙蛋白T联合检测对急性非ST段抬高型心肌梗死的早期诊断价值

Early diagnosis value of heart-type fatty acid binding protein, red blood cell distribution width and cardiac troponin T combined detection for non-ST-segment elevation acute myocardial infarction

作者：邓凤珠李春富符海燕李天发

英文作者：Deng Fengzhu Li Chunfu Fu Haiyan Li Tianfa

单位：海南西部中心医院心电图室，海南省儋州市571700

英文单位：Electrocardiogram Room Hainan West Central Hospital Hainan Province Danzhou 571700 China

关键词：急性非ST段抬高型心肌梗死；心型脂肪酸结合蛋白；红细胞体积分布宽度；心肌肌钙蛋白T；早期诊断价值

英文关键词：Non-ST-segmentelevationacutemyocardialinfarction；Heart-shapedfattyacidbindingprotein；Redbloodcellvolumedistributionwidth；CardiactroponinT；Earlydiagnosticvalue

• 摘要：

• 【摘要】目的    研究心型脂肪酸结合蛋白（H-FABP）、红细胞体积分布宽度（RDW）及心肌肌钙蛋白T（cTnT）联合检测对急性非ST段抬高型心肌梗死（NSTEMI）的早期诊断价值。方法    选取2016年8月至2019年8月海南西部中心医院接诊的86例疑似NSTEMI患者，最终确诊为NSTEMI患者45例，定为NSTEMI组，非NSTEMI患者41例（非心源性胸痛22例、心绞痛19例）定为非NSTEMI组。另选取43名同期体检健康者为对照组。将NSTEMI组患者冠状动脉病变程度依据Gensini积分分为轻度组、中度组及重度组。比较NSTEMI组、非NSTEMI组和对照组的H-FABP、RDW、cTnT水平；比较NSTEMI组不同冠状动脉病变程度患者H-FABP、RDW、cTnT水平；通过绘制受试者工作特征曲线，分析H-FABP、RDW、cTnT单独及联合检测诊断早期NSTEMI的临床价值。结果    NSTEMI组H-FABP、RDW、cTnT水平均高于非NSTEMI组和对照组［（8.4±1.3）μg/L比（7.3±1.1）、（3.9±0.4）μg/L，（14.7±2.0）%比（13.4±2.1）%、（12.1±1.9）%，（0.59±0.08）μg/L比（0.31±0.04）、（0.09±0.01）μg/L］，非NSTEMI组H-FABP、RDW、cTnT水平均高于对照组，差异均有统计学意义（均P＜0.05）。重度组H-FABP、RDW、cTnT水平均高于中度组和轻度组，中度组H-FABP、RDW、cTnT水平均高于轻度组，差异均有统计学意义（均P＜0.05）。受试者工作特征曲线结果显示，H-FABP、RDW、cTnT单独检测诊断早期NSTEMI的最佳截断点分别为8.95 μg/L、14.73%、0.67 μg/L，曲线下面积分别为0.750、0.742、0.781，三者联合检测的曲线下面积为0.813。结论    H-FABP、RDW、cTnT与NSTEMI冠状动脉病变程度有关，且三者联合检测对NSTEMI的早期诊断具有重要价值。

• 【Abstract】Objective    To analyze the early diagnostic value of combined detection of heart-type fatty acid binding protein(H-FABP), red blood cell volume distribution(RDW) and cardiac troponin T(cTnT) in non-ST-segment elevation acute myocardial infarction(NSTEMI). Methods    From August 2016 to August 2019, 45 NSTEMI patients (NSTEMI group), 41 non-NSTEMI patients(non-NSTEMI group, 22 cases of non cardiogenic chest pain and 19 cases of angina pectoris) and 43 healthy volunteers（control group） were enrolled at Hainan West Central Hospital. According to Gensini score, NSTEMI patients were divided into mild group, moderate group and severe group. Levels of H-FABP, RDW and cTnT were detected. Values of H-FABP, RDW and cTnT in early diagnosis of NSTEMI were analyzed by receiver operating characteristic（ROC） curve. Results    Levels of H-FABP, RDW and cTnT in NSTEMI group were higher than those in non-NSTEMI group and control group［（8.4±1.3）μg/L vs （7.3±1.1）,（3.9±0.4）μg/L; （14.7±2.0）% vs （13.4±2.1）%,（12.1±1.9）%; （0.59±0.08）μg/L vs （0.31±0.04）,（0.09±0.01）μg/L］ and the indexes in non-NSTEMI group were higher than those in control group(all P＜0.05). Levels of H-FABP, RDW and cTnT in severe group were higher than those in moderate group and mild group; the indexes in moderate group were higher than those in mild group(all P＜0.05). ROC curve analysis showed that the best cut-off points of H-FABP, RDW and cTnT were 8.95 μg/L, 14.73%, 0.67 μg/L and the areas under curve were 0.750, 0.742 and 0.781, respectively; the area under curve of combined detection was 0.813. Conclusions    H-FABP, RDW and cTnT are related to the severity of coronary artery lesion in patients with NSTEMI. Combined detection of the three indexes can improve early diagnosis of NSTEMI.