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首页> 外文期刊>Hong Kong journal of emergency medicine. >Serial Measurement of Heart-Type Fatty Acid Binding Protein for the Rapid Diagnosis of Acute Coronary Syndromes in the Emergency Department
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Serial Measurement of Heart-Type Fatty Acid Binding Protein for the Rapid Diagnosis of Acute Coronary Syndromes in the Emergency Department

机译：心脏型脂肪酸结合蛋白的系列检测，用于急诊急诊冠状动脉综合征的快速诊断

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We aimed to investigate the diagnostic accuracy of heart-type fatty acid binding protein (H-FABP) at admission and the third and sixth hour after admission in patients presenting to the emergency department (ED) with chest pain or equivalent symptoms. This prospective study was performed over two months in the ED. Patients presenting with ischaemic-type chest pain or other symptoms suggestive of myocardial ischaemia were included in the study. A bedside, point-of-care, quantitative H-FABP level was measured. If the initial electrocardiography (ECG) was non-diagnostic, the patients were observed for six hours. During the observation period, serial H-FABP measurements were obtained at admission, the third hour and the sixth hour; serial measurements of total creatine kinase (CK), CK-MB, troponin I and myoglobin were recorded at admission and the sixth hour. A total of 183 patients were included in the study. Initial H-FABP was measured in a joint group of ST segment elevation myocardial infarction (STEMI) and non ST segment elevation myocardial infarction (NSTEMI) patients, with a sensitivity of 80.9%, specificity of 19.2%, positive predictive value (PPV) of 23% and negative predictive value (NPV) of 77.1%. The third-hour H-FABP was measured in the NSTEMI group, with a sensitivity of 46.7%, specificity of 80.2%, PPV of 42.4% and NPV of 82.6%. The sixth-hour H-FABP had a sensitivity of 33.3%, specificity of 73.9%, PPV of 24.2% and NPV of 81.5%. H-FABP is superior to myoglobin for diagnosing myocardial infarction in a joint group of STEMI and NSTEMI patients. The third-hour NPV value for H-FABP indicates that, for safety considerations, the cardiac observation time should not be shortened. (Hong Kong j.emerg.med. 2014;21:213-221).
机译：我们的目的是研究在就诊时以及出现胸痛或同等症状的急诊科（ED）的患者入院时以及入院后第三和第六小时心脏型脂肪酸结合蛋白（H-FABP）的诊断准确性。这项前瞻性研究在急诊室进行了两个多月。该研究包括表现为局部缺血型胸痛或其他提示心肌缺血的症状的患者。测量了床旁即时护理的定量H-FABP水平。如果最初的心电图（ECG）无法诊断，则对患者进行6个小时的观察。在观察期间，在入院时，第三小时和第六小时获得了连续的H-FABP测量值。入院时和第6小时记录总肌酸激酶（CK），CK-MB，肌钙蛋白I和肌红蛋白的系列测量值。该研究总共包括183名患者。在ST段抬高心肌梗死（STEMI）和非ST段抬高心肌梗死（NSTEMI）患者的联合组中测量最初的H-FABP，敏感性为80.9％，特异性为19.2％，阳性预测值（PPV）为。 23％和77.1％的阴性预测值（NPV）。在NSTEMI组中测量了第三小时的H-FABP，灵敏度为46.7％，特异性为80.2％，PPV为42.4％，NPV为82.6％。第六小时H-FABP的敏感性为33.3％，特异性为73.9％，PPV为24.2％，NPV为81.5％。在STEMI和NSTEMI患者的联合组中，H-FABP在诊断心肌梗塞方面优于肌红蛋白。 H-FABP的第三小时NPV值表明，出于安全考虑，不应缩短心脏观察时间。 （Hong Kong j.emerg.med.2014; 21：213-221）。

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