心型脂肪酸結合蛋白聯合斑點追蹤成像技術對急性心肌梗死患者心肌收縮功能評價的研究

劉楊瑒　趙瑞平

【摘要】 目的：對急性心肌梗死（AMI）患者的血清心型脂肪酸結合蛋白（H-FABP）濃度與其心肌應變量參數的相關性進行研究，從而為病情判定及預后評估提供依據。方法：連續入選初發AMI患者125例并分為急性ST段抬高型心肌梗死組和急性非ST段抬高型心肌梗死組，將急性ST段抬高型心肌梗死組分為各個亞組（急性前壁心肌梗死組、急性下壁心肌梗死組）。所有入組患者于入院即刻采血行H-FABP檢測。同時行彩色多普勒超聲檢查并利用斑點追蹤成像技術測定左心室縱向應變值、圓周應變值。對各組患者H-FABP濃度與心肌應變值的相關性進行分析，研究心肌梗死患者H-FABP濃度與心肌應變值是否相關。結果：急性ST段抬高型心肌梗死組患者左室整體縱向應變、圓周應變與血清H-FABP濃度成正相關（P<0.01）。急性前壁心肌梗死組患者左室整體縱向應變與血清H-FABP濃度成正相關（P<0.01）。急性下壁心肌梗死組患者左室整體縱向應變、整體圓周應變與血清H-FABP濃度成正相關（P<0.01）。急性非ST段抬高型心肌梗死組患者左室整體圓周應變與血清H-FABP濃度成正相關（P<0.01）。結論：AMI患者血清H-FABP濃度與心肌應變量相關，血清H-FABP可與斑點追蹤成像技術聯合評價心肌梗死患者心肌收縮功能。

【關鍵詞】 急性心肌梗死； 心型脂肪酸結合蛋白； 斑點追蹤成像； 應變； 收縮能力

Study of Heart Type Fatty Acid Binding Protein Combined with Speckle Tracking Imaging of Myocardial Systolic Function in Patients with Acute Myocardial Infarction Evaluation/LIU Yang-yang，ZHAO Rui-ping.//Medical Innovation of China，2017，14（30）：124-128

【Abstract】 Objective：To investigate the correlation between serum heart-type fatty acid binding protein （H-FABP） and myocardial strain parameters in patients with acute myocardial infarction （AMI），so as to provide a basis for disease assessment and prognosis assessment.Method：125 patients with newly diagnosed AMI were divided into the acute ST-segment elevation myocardial infarction group and the acute non-ST-elevation myocardial infarction group.The acute ST-segment elevation myocardial infarction was divided into subgroups（acute anterior myocardial infarction group and acute inferior wall myocardial infarction group）.All patients enrolled in the hospital were immediately collected blood for H-FABP detection.At the same time，color Doppler ultrasonography was performed and the left ventricular longitudinal strain and circumferential strain were measured by spot tracking imaging.The correlation between H-FABP concentration and myocardial strain in each group was analyzed，investigated whether H-FABP concentration was related to myocardial strain in patients with myocardial infarction.Result：The left ventricular longitudinal strain and circumferential strain of patients with acute STEMI were positively correlated with serum H-FABP concentration（P<0.01）.There was a positive correlation between left ventricular longitudinal strain and serum H-FABP concentration in patients with acute anterior myocardial infarction（P<0.01）.There was a positive correlation between left ventricular circumferential strain and serum H-FABP concentration in patients with acute inferior myocardial infarction（P<0.01）.The left ventricular circumferential strain of patients with acute NSTEMI was positively correlated with serum H-FABP concentration（P<0.01）.Conclusion：Serum H-FABP concentration is associated with myocardial strain，H-FABP can be used to evaluate the cardiac systolic function in patients with AMI by spot tracking imaging.endprint

【Key words】 Acute myocardial infarction； Heart-type fatty acid binding protein； Spot tracking imaging； Strain； Cardiac systolic function

First-authors address：Baotou Medical College，Baotou 014000，China

doi：10.3969/j.issn.1674-4985.2017.30.037

急性心肌梗死（Acute myocardial infarction，AMI）是心血管內科常見的危重癥，具有起病急、發病迅速、病死率高等特點，嚴重影響人類的身體健康與生活質量。心力衰竭是心肌梗死常見的并發癥之一，心肌細胞缺血壞死后一系列病理生理改變引發心功能減低，心肌收縮及舒張功能減弱，AMI患者發生心功能減低同時預示著其預后不良及心臟不良事件的風險。及早對急性心肌梗死患者的心功能進行準確、合理的評估并根據病情選擇合理、科學的治療方案對患者的預后意義重大。心型脂肪酸結合蛋白（Heart-type fatty acid-binding protein，H-FABP）在急性心肌梗死患者發病的早期即出現可檢出性增高，經過近幾年的臨床實踐，H-FABP已廣泛應用于急性心肌梗死的診療過程，對于AMI的早期診斷、病情評估及預測預后有一定的輔助作用?！?br>