缺血修饰白蛋白与CK-MB在AMI早期诊断中的应用价值

Value of Ischemia Modified AlbUmin and CK-MB in Early Dlagnosis of AMI

目的:探讨缺血修饰白蛋白(IMA)与心肌型肌酸激酶同工酶MB(CK-MB)检测在急性心肌梗死(AMI)的早期诊断价值。方法:AMI患者200例胸痛发作3～6小时之内取样待检,其中32例血清做3h、6h、12h、24h、2d、4d动态检测IMA、CK-MB水平,另选260例健康体检者做正常对照组,评价IMA和CK-MB对ACS诊断的临床价值。结果:对照组260例IMA均值为(56.5±6.7)ABSu/ml;CK-MB均值为(10.3±5.5)u/L。AMI组200例IMA均值为(87.5±11.3)ABSu/ml,数据分布范围宽,与对照组数据比较上升趋势明显;CK-MB均值为(38.2±15.3)u/L。对照组与AMI组数据相比有显著性意义(P<0.01)。CK-MB在6h内升高不明显,6h后开始上升并持续至24h以后逐渐下降,2d时接近正常水平,4d恢复到正常水平。IMA在3h时就明显上升,6h后就明显下降,24h时恢复到正常水平。结论:IMA和CK-MB在AMI早期具有较高的敏感度和特异性,可作为早期诊断AMI的辅助指标。

Objective： To discuss the value of ischemia modified albumin（IMA） and creatine kinase-MB（CK-MB）in early diagnosis of acute myocardial infarction （AMI）. Methods： The serum IMA and CK-MB levels in 200 patients of AMI presenting within 3-6 hours of acute chest pain were detected. Among them, 32 samples were detected the IMA and CK-MB levels of 3h, 6h, 24h, 2d, 4d. after chest pain. 260 healthy volunteers were recruited to be the control group. Results： Serum mean IMA and CK..MB levels of the control group were（56.5 ±6.7）ABSu/ml and （10.3±5.5）u/L respectively. Serum mean IMA level of the 200 AMI patients was （87.5±11.3）ABSu/ml, data distribution range was broad and has ascansus tendency as compaired with control group. Serum mean CK-MB level of the 200 AMI patients was （38.2± 15.3）u/L and significantly higher than that of the control group（P〈0.01）.The CK-MB level did not increased obviously within 6h, begun to increased after 6h and continued to 24h, then it decresased and approached to normal levels after 2d and reverted normal levels after 4d. The IMA level increased obviously after 3h and decreased obviously after 6h, then reverted normal levels after 24h. Conclusions： IMA and CK- MB has higher sensitivity and specificity in early phase of AMI,and it can be an ideal marker in the early diagnosis of AMI.