急性期脑梗死患者早期伴发心功能及心肌细胞损害的临床监测

目的通过观察急性期脑梗死（ACI）患者血清N末端B型钠尿肽原（NT—proBNP）和心型脂肪酸结合蛋白（h—FABP）水平变化，探讨其伴发早期心功能及心肌细胞损害的监测价值。方法选择95例ACI患者和50例健康对照组为研究对象，血清NT—proBNP检测采用电化学发光免疫分析（ECLIA）法，血清h-FABP检测采用双抗体夹心酶联免疫（ELISA）一步法。结果（1）血清NT—proBNP和h-FABP水平，ACI患者急性期显著高于恢复期及对照组（P〈0．01）；大面积ACI患者显著高于小面积ACI患者（P〈0．01）；恢复期患者与对照组相比，差异无显著性（P〉0．05）。（2）ACI急性期患者血清NT—proB—NP阳性率（54．74％）显著低于血清h-FABP的阳性率（82．11％）（P〈0．01），且两者具有相关一致性。③ACI急性期患者血清h—FABP水平与NT—proBNP呈显著正相关（r=0．719，P〈0．01），相关性良好。结论ACI急性期患者血清NT—proBNP和h-FABP水平显著升高，且具有相关性，联合检测其水平变化，对诊断ACI并发早期心功能及心肌细胞损害具有临床检测价值。

The acute phase ACI patients comorbid early cardiac function and myocardial cell damage monitoring

Objective Through the observation of the acute phase ACI patients serum NT-proBNP and h-FABP level change, discuss the accompanying early cardiac function and myocardial cell damage monitoring value. Methods The method and ELISA re- spectively ECLIA step method,tested the 95 cases of ACI patients and fifty cases of control group serum NT-proBNP and h-FABP level. Results ACI patients with the acute phase of serum NT-proBNP and h-FABP level were significantly higher than those in the control group（ P 〈 0. 01 ）, is also significantly higher recovery ACI patients（ P 〈 0. 01 ）, CI monitoring patients compared with no significant difference（ P 〉 0.05 ）. Large areas of ACI patients serum NT-proBNP and h-FABP level were significantly higher than the small area of ACI patients （ P 〈 0.01 ）. ACI patients with the acute phase of serum NT-proBNP positive rate （ 54.74% ） significantly lower than serum h-FABP positive rate of（82. 11% ） （P 〈0. 01 ） ,and the related consistency. ACI patients with the acute phase of serum h-FABP level and NT-proBNP is a significant positive correlation （ r = 0. 719, P 〈 0. 01 ）, and the correlation is good. Conclusion ACI patients with the acute phase of serum NT-proBNP and h-FABP level increased significantly, and has relevance ,joint detection its level can timely know concurrent early myocardial cell damage and cardiac function ,to guide treatment and improve prognosis is of great significance.