CAJ | 학술논문

目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术前、术后心型脂肪酸结合蛋白(H - FABP)的动态变化和临床意义.方法本研究采用固相夹心酶联免疫法(ELISA)测定50例AMI患者发病后6h以内(PCI术前)及发病后9、12、24、48h血浆H-FABP、心肌肌钙蛋白Ⅰ、肌酸激酶同工酶浓度；将实验组分为死亡组、并发症组和无并发症组进行对比分析.结果急性心肌梗死患者血浆H - FABP浓度明显高于正常对照组,差异有统计学意义(P＜0.01)；在三个亚组中,无并发症组患者血浆H-FABP浓度在发病后4～6h达高峰,12～24 h恢复到正常范围；而并发症组和死亡组患者血浆H-FABP浓度在各个时间点都高于无并发症组,而且峰值延迟、持续不降并有增高趋势.三组的组间、不同时间点以及组间和不同时间点的交互作用比较差异均有统计学意义(P＜0.05).结论 H -FABP是急性心肌梗死早期诊断的特异性生化标记物,对AMI有重要的诊断价值.AMI患者血浆H- FABP峰值延长甚至持续升高可能为心肌梗死后各种并发症对心肌细胞的持续损伤有关,H-FABP浓度的动态变化对AMI患者危险分层有一定的预测价值.
목적 탐토급성심기경사(AMI)환자경피관상동맥개입치료(PCI)술전、술후심형지방산결합단백(H - FABP)적동태변화화림상의의.방법 본연구채용고상협심매련면역법(ELISA)측정50례AMI환자발병후6h이내(PCI술전)급발병후9、12、24、48h혈장H-FABP、심기기개단백Ⅰ、기산격매동공매농도；장실험조분위사망조、병발증조화무병발증조진행대비분석.결과 급성심기경사환자혈장H - FABP농도명현고우정상대조조,차이유통계학의의(P＜0.01)；재삼개아조중,무병발증조환자혈장H-FABP농도재발병후4～6h체고봉,12～24 h회복도정상범위；이병발증조화사망조환자혈장H-FABP농도재각개시간점도고우무병발증조,이차봉치연지、지속불강병유증고추세.삼조적조간、불동시간점이급조간화불동시간점적교호작용비교차이균유통계학의의(P＜0.05).결론 H -FABP시급성심기경사조기진단적특이성생화표기물,대AMI유중요적진단개치.AMI환자혈장H- FABP봉치연장심지지속승고가능위심기경사후각충병발증대심기세포적지속손상유관,H-FABP농도적동태변화대AMI환자위험분층유일정적예측개치.
Objective To investigate the dynamic changes and clinical significance of the preand post -operation plasma H -FABP in patients with AMI.Methods This study adopts ELISA to assay H - FABP,cTnI,CK - MB concentrations in plasma at 0 - 6,9,12,24,and 48 hours after presentation in 50 patients with AMI.The AMI group was divided into three subgroups:the death subgroup,the complication subgroup and the non -complication subgroup and they were relatively analyzed.Results H - FABP concentrations in plasma of patients with AMI was higher than that of the controls,and the difference between them has statistical significance( P ＜0.01 ).Among the three subgroups,H -FABP levels in plasma came to peak in the non - complication subgroup at 4 - 6 hours after presentation,then it returned to normal range at 12 -24 hours after presentation.H -FABP levels in both thecomplication subgroup and the death subgroup were obviously higher than that in the non -complication subgroup at each time point.Their peaks were delayed,remained high and had an increase trend,Among the three subgroups,the different time points,and the interaction of among groups and the different time points,the three differences were statistically significant ( P ＜ 0.05).Conclusions H - FABP was a specific biochemical marker in the early diagnosis of acute myocardial infarction and it was fairly important for the diagnosis of AMI.The extension and even continuous rise of its peak are probably related to the damage of myocardial cell caused by many complication after AMI.The dynamic change of HFABP concentration has predictive values in the risk stratification of AMI patients.