廖慧,何睿颖,邹艳
LIAO Hui,HE Ruiying,ZOU Yan

• 1:成都市第三人民医院心内科

摘要(Abstract)：

目的 探讨血清心型脂肪酸结合蛋白（H-FABP）、心肌肌钙蛋白Ⅰ（cTnⅠ）、N-末端脑钠肽前体（NTproBNP）在急性心肌梗死伴心衰患者中的表达及对患者预后的预测价值。方法 选取124例急性心肌梗死伴心衰患者作为病例组、再根据治疗3个月后的心源性不良事件发生情况分为预后不佳组和预后良好组，选取同期85例健康体检者作为对照组；检测病例组和对照组受试者入院或体检时的血清H-FABP、cTnⅠ、NT-proBNP水平，同时测定病例组患者左室射血分数（LVEF）、左室舒张末期容积指数（LVEDVI）、左室收缩末期容积指数（LVESVI），采用Pearson法分析病例组血清H-FABP、cTnⅠ、NT-proBNP与LVEF、LVEDVI、LVESVI的相关性，用受试者特征工作曲线（ROC）曲线下面积（AUC）评价血清H-FABP、cTnⅠ、NT-proBNP对预测急性心肌梗死伴心衰的价值。结果 病例组血清H-FABP、cTnⅠ、NT-proBNP及LVEDVI、LVESVI高于对照组（P<0.05）,LVEF低于对照组（P<0.001）；预后不佳的病例组患者血清H-FABP、cTnⅠ、NT-proBNP高于预后良好组（P<0.001）;Pearson相关性分析结果显示，血清H-FABP、cTnⅠ、NT-proBNP与LVEF呈负相关关系（P<0.05），与LVEDVI、LVESVI呈正相关关系（P<0.05）; ROC曲线显示，血清H-FABP、cTnⅠ、NT-proBNP预测急性心肌梗死并心衰患者预后的AUC为0.858、0.879及0.839，约登指数最大时的截点值为221.42μg/L、1.12μg/L及1 641.63 ng/L。结论 血清H-FABP、cTnⅠ、NT-proBNP水平预测急性心肌梗死合并心衰患者具有一定的价值。
Objective To investigate the expression of serum heart-type fatty acid binding protein(H-FABP), cardiac troponin I(cTn I) and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with acute myocardial infarction and heart failure, and their prognostic value.Methods One hundred and twenty-four patients with acute myocardial infarction and heart failure(case group), and85 healthy individuals(control group) were selected as the research subjects. The levels of serum HFABP, cTnⅠ, and NT-proBNP in the two groups were tested. The left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume index( LVEDVI), and left ventricular end-systolic volume index(LVESVI) in the case group were determined. The occurrence of cardiogenic adverse events at 3 months after treatment was counted. The receiver operating characteristic(ROC) curve was used to analyze the prognostic value of serum H-FABP, cTnⅠ,and NT-proBNP.Results Serum HFABP, cTnⅠ, and NT-proBNP in the case group were significantly higher than those in the control group(P< 0. 05), LVEF was lower than in the control group(P< 0. 05), and LVEDVI and LVESVI were higher than those in the control group(P< 0. 001). Pearson correlation analysis showed that serum H-FABP, cTnⅠ, and NT-proBNP were negatively correlated with LVEF(P< 0. 05), and were positively correlated with LVEDVI and LVESVI(P< 0. 05). Serum H-FABP, cTn Ⅰ, and NTproBNP in the poor prognosis group were significantly higher than those in the good prognosis group(P< 0. 05). ROC curve analysis found that the area under the curve values of serum H-FABP, cTnⅠ, and NT-proBNP for prognosis of patients with acute myocardial infarction and heart failure were0. 858, 0. 879, and 0. 839 respectively. The cut-off values at the maximum Youden index were221. 42 μg/L, 1. 12 μg/L, and 1 641. 63 ng/L respectively.Conclusion Patients with acute myocardial infarction and heart failure may be accompanied by elevated serum H-FABP, cTnⅠ, and NT-proBNP levels which are closely related to the patients' cardiac function and prognosis. Therefore,the above indicators can provide certain reference for clinical treatment.

关键词(KeyWords)： 急性心肌梗死;心力衰竭;心型脂肪酸结合蛋白;心肌肌钙蛋白Ⅰ;N-末端脑钠肽前体
acute myocardial infarction;heart failure;heart-type fatty acid binding protein;cardiac troponin Ⅰ（cTnⅠ）； N-terminal pro-brain natriuretic peptide(NT-proBNP)

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生健康委员会科研课题（19PJ168）

作者(Author): 廖慧,何睿颖,邹艳
LIAO Hui,HE Ruiying,ZOU Yan

DOI: 10.19367/j.cnki.2096-8388.2022.04.018

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