深圳市第七人民医院 汪润 余杨 朱红秋 朱平安

    【摘要】目的：采用联合测定心型脂肪酸结合蛋白（heart fatty acid binding protein， h-FABP）、肌钙蛋白T（cTnT）探讨尽可能早期诊断急性心肌损伤的方法。方法：对76例急性冠脉综合征（ACS）患者，自胸痛发生后一小时开始每小时连续监测心型脂肪酸结合蛋白、肌钙蛋白T至胸痛发生后6小时，共六次。以h-FABP>15μg/L、cTnT>0.1μg/L作为阳性标准，分析h-FABP或/和cTnT阳性结果对早期诊断ACS的意义。结果：在早期急性心肌损伤中，h-FABP阳性结果出现的时间早于cTnT，二者对比有统计学意义（P<0.05）。在cTnT升高病人中， h-FABP升高率为98.7%，二者对比无统计学差异（P>0.05）。结论：在诊断早期急性心肌损伤时 ，h-FABP出现阳性结果时间早于cTnT，而联合测定h-FABP、cTnT对提高ACS患者早期确诊率，指导临床急救具有重要的价值。

    【关键词】 脂肪酸结合蛋白 肌钙蛋白T 急性心肌损伤 早期诊断

    Combination determination for heart fatty acid binding protein( h-FABP) and cardiac Troponin T (cTnT) in early diagnosing acute myocardial injury

    Summary

    Objective To estimate a way for quickly diagnosing acute myocardial injury by measuring heart fatty acid binding protein( h-FABP) together cardiac Troponin T. Methods 76 patients with acute conoary syndrome (ACS) were studied. H-FABP and cTnT was measured in these patients from one hour after chest pain, once an hour, together six times. h-FABP>15μg/L or cTnT>0.1μg/L was positive. We estimated the clinical value of h-FABP or cTnT positive content in quickly diagnosing acute myocardial injury. Results h-FABP positive content occurred earlier than cTnT in acute myocardial infarction. The difference is significant. The h-FABP positive rate is 98.7% among the patients with cTnT content >0.1μg/L. The difference of positive rate is no significant. Conclusion The h-FABP positive content occurred earlier than cTnT in early diagnosing acute myocardial injury. Combination determination for h-FABP and cTnT is useful for early diagnosis of acute myocardial injury and important to direct clinical emergency. ......