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目的探讨心型脂肪酸结合蛋白(H-FABP)、高敏肌钙蛋白T(hs-cTnT)、氨基末端B型钠尿肽原(NT-proBNP)检测对慢性心力衰竭(CHF)的诊断价值。方法选择慢性心力衰竭患者101例为心衰组(CHF组),将CHF组分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级4个亚组,同时选取健康体检者25例为对照组。检测血清H-FABP、hs-cTnT及NT-proBNP浓度。结果 CHF组的H-FABP、hs-cTnT和NT-proBNP水平较对照组均显著升高,差异具有统计学意义(P<0.05);心衰组各亚组间H-FABP、hs-cTnT和NT-proBNP差异均有统计学意义(P<0.05),且随心功能分级增加逐渐增高;心衰亚组Ⅰ级组较对照组H-FABP、hs-cTnT水平升高,差异具有统计学意义(P<0.05);血清NT-proBNP水平变化与hs-cTnT、H-FABP呈正相关,r值分别为0.354 4和0.517 6,P值<0.05。非重症心力衰竭患者血清中多项标志物联合检测的灵敏度显著高于单项检测的灵敏度。结论联合检测H-FABP、hs-cTnT和NT-proBNP有助于慢性心力衰竭早期诊断,值得在临床工作中推广应用。
Objective To investigate the diagnostic value of H-FABP, hs-cTnT and NT-proBNP in patients with chronic heart failure (CHF). Methods One hundred and ten patients with chronic heart failure were selected as the CHF group. The CHF group was divided into four subgroups Ⅰ, Ⅱ, Ⅲ and Ⅳ. At the same time, 25 healthy subjects were selected as the control group. Serum H-FABP, hs-cTnT and NT-proBNP concentrations were measured. Results The levels of H-FABP, hs-cTnT and NT-proBNP in CHF group were significantly higher than those in control group (P <0.05). H-FABP, hs-cTnT and NT-proBNP were significantly different (P <0.05), and increased gradually with the increase of cardiac function grade. The levels of H-FABP and hs-cTnT in heart failure subgroup Ⅰ group were significantly higher than those in control group P <0.05). The level of serum NT-proBNP was positively correlated with hs-cTnT and H-FABP, with r values of 0.354 4 and 0.517 6, respectively, P <0.05. The sensitivity of combined detection of multiple markers in serum of patients with non-severe heart failure was significantly higher than the sensitivity of single detection. Conclusions Combined detection of H-FABP, hs-cTnT and NT-proBNP is helpful for the early diagnosis of chronic heart failure and should be widely applied in clinical practice.