Fukuda Yusuke, Miura Shin-ichiro, Zhang Bo, Iwata Atsushi, Kawamura Akira, Nishikawa Hiroaki, Shirai Kazuyuki, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka.
Intern Med. 2009;48(19):1731-7. doi: 10.2169/internalmedicine.48.2410. Epub 2009 Oct 1.
We investigated the significance of urinary liver fatty acid-binding protein (U-L-FABP) monitoring during cardiac catheterization in patients with cardiovascular disease (CVD). Methods The subjects included 27 consecutive patients with stable angina (SAP group) or acute coronary syndrome (ACS group) who had undergone successful percutaneous coronary intervention (PCI), and 12 patients were also enrolled as controls (C group). Urinary and serum parameters were measured immediately before and after and 1 day after PCI.
The ratio of U-L-FABP to U-creatinine (U-Cr) (U-L-FABP/U-Cr) in the ACS group was significantly higher than those in both the SAP and C groups before PCI. In addition, none of the patients in the SAP group showed contrast-induced nephropathy (CIN) based on the levels of serum (S)-Cr and U-L-FABP/U-Cr after PCI. Although none of the patients in the ACS group showed CIN according to S-Cr, the level of U-L-FABP/U-Cr was continuously high throughout the study period. Moreover, since there were significant differences in U-L-FABP/U-Cr, U-N-acetyl-beta-D-glucosaminidase, S-uric acid and % medication with calcium channel blockers before PCI between the ACS and SAP groups, a multiple regression analysis was performed using these parameters. It showed that U-L-FABP/U-Cr was most closely associated with the classification of SAP and ACS (p<0.0001). The cut-off level for the greatest sensitivity and specificity for U-L-FABP for the diagnosis of ACS was 13.4 microg/g. Cr in all subjects (sensitivity 0.800, specificity 0.963).
To the best of our knowledge, this is the first report indicating that the measurement of U-L-FABP can be beneficial for in the diagnosis of ACS.
我们研究了心血管疾病（CVD）患者在心脏导管插入术期间监测尿肝脂肪酸结合蛋白（U-L-FABP）的意义。方法：受试者包括27例连续成功接受经皮冠状动脉介入治疗（PCI）的稳定型心绞痛患者（SAP组）或急性冠状动脉综合征患者（ACS组），另有12例患者作为对照组（C组）。在PCI术前、术后及术后1天立即测量尿和血清参数。
PCI术前，ACS组U-L-FABP与尿肌酐（U-Cr）的比值（U-L-FABP/U-Cr）显著高于SAP组和C组。此外，根据PCI术后血清（S）-Cr和U-L-FABP/U-Cr水平，SAP组患者均未出现造影剂肾病（CIN）。虽然ACS组患者根据S-Cr均未出现CIN，但在整个研究期间U-L-FABP/U-Cr水平持续升高。此外，由于ACS组和SAP组在PCI术前U-L-FABP/U-Cr、U-N-乙酰-β-D-氨基葡萄糖苷酶、S-尿酸以及使用钙通道阻滞剂的药物百分比存在显著差异，因此使用这些参数进行了多元回归分析。结果显示，U-L-FABP/U-Cr与SAP和ACS的分类最为密切相关（p<0.0001）。所有受试者中，U-L-FABP诊断ACS的最大敏感性和特异性的截断水平为13.4μg/g·Cr（敏感性0.800，特异性0.963）。
据我们所知，这是第一份表明测量U-L-FABP对ACS诊断有益的报告。
