缺血修饰白蛋白与平板运动试验联合检查对早期冠状动脉综合征的临床诊断意义

Significant of combining ischemia modified albumin detection with the treadmill exercise testing for the diagnosis of early acute coronary syndromes

目的探讨缺血修饰白蛋白(IMA)测定与平板运动试验联合诊断早期冠脉综合征的临床应用价值。方法以30例体检健康者做为对照,对80例心肌缺血、缺氧症状患者分别进行平板运动试验(TET)、冠状动脉造影(CAG)以及检测其运动前后的IMA值。比较运动试验前后患者与健康对照组IMA测定值的变化;以冠脉造影结果为标准,分别评价IMA、TET、IMA联合TET对于诊断早期冠状动脉综合征敏感性与特异性。结果运动试验前试验组IMA值与对照组差异显著(P<0.05);运动试验后试验组IMA值显著升高(P<0.01);IMA诊断早期冠脉综合征的特异性为85.3%,敏感性为93.5%;TET诊断早期冠脉综合征的特异性为67.6%,敏感性为89.1%;IMA联合TET诊断早期冠脉综合征的特异性为94.1%,敏感性为87.0%。结论IMA联合TET检查可显著提高早期冠状动脉综合征诊断的特异性,降低以IMA或TET单纯检查进行诊断时的假阴性和假阳性率,极大提高诊断的准确性。

Objective To evaluate the clinical significant of the detection of ischemia modified albumin（IMA） combined with treadmill exercise testing（TET） for the diagnosis of early acute coronary syndromes（ACS） .Methods To perform the coronary arteriography （CAG） and Treadmill exercise testing on 80 patients who have the symptom of myocardial ischemia and myocardial anoxia. And then detected the IMA values of whose before and after TET. 30 healthy person were as the normal control group. The IMA values of patients before and after TET were compared. The patients accepted CAG were confirmed if they had the early ACS. Evaluation of the diagnosis specificity and sensibihty of IMA,TET and co-detection of IMA and TET for diagnosis of early ACS. Results The IMA values before TET have difference between the test group and the control group（ P 〈 0.05）. The IMA values increased evidently in test group after TET （P 〈 0.01 ）. The diagnosis specificity and sensibility of IMA,TET and co-detection of IMA and TET for early ACS are 85.3% and 93.5% ;67.6% and 98.1% ;94.1% and 87.0% respectively. Conclusion Co-detection of IMA and TET can obviously increase the specificity rate for diagnosis of early ACS. It can also degrade the rate of false positive and false negative caused by simply detecting of the IMA values or TET, and also make the diagnosis for early ACS more reliable.