缺血修饰白蛋白与肌钙蛋白联合测定对急性冠脉综合征的早期诊断价值

Significance of the Quantitative Analysis of Ischemia Modified Albumin and Troponin for Early Diagnosis of Acute Coronary Syndrome

目的探讨缺血修饰白蛋白（IMA）与肌钙蛋白（cTnI）联合测定对急性冠脉综合征（ACS）的早期诊断意义。方法97例在发病6h内就诊的ACS患者，包括不稳定型心绞痛（UA）61例和心肌梗死（MI）36例，入院后分别于即刻、6h、24h测定IMA、cTnI，并行心电图（ECG）检查，比较两组患者IMA及cTnI的水平差异，且与对照组比较，分析IMA、cTnI和ECG单项或联合诊断ACS的敏感性。结果即刻检测：两组患者的IMA水平均明显升高；而cTnI在MI组升高明显，IMA、cTnI和ECG单项诊断ACS的敏感性分别为87．6％、44．3％和41．2％；IMA联合cTnI以及三者联合诊断ACS的敏感度高达91．7％及94．8％，均高于单项诊断的敏感性，差异具有显著统计学意义（P〈0．05），6h联合测定敏感性也高于单项检测，有显著统计学差异（P〈0．05）。结论IMA是早期诊断ACS的敏感生化指标，尤其对UA的诊断有着较高的敏感性，IMA、cTnI及ECG联合检测，可进一步提高对ACS的早期诊断价值。

Objective To explore significance of the quantitative analysis of Ischemia Modified Albumin and Troponin for early acute coronary syndrome. Methods 97 patients with an attack of ACS in 6 hours were assigned to Unstable Angina Pectoris group（61 cases）and Myocardial Infarction group（ 36cases）. The variation laws were observed respectively by continuously measuring IMA, cTnT and ECG for the patients in 0 hour,6 hour,24 hour after admission. Results In 0 hour after admission, the level of IMA was significantly increased in the two groups patients, and the level of eTnI was significantly increased only in MI group. The sensitivity of IMA, eTnI and ECG to ACS was 87.6% ,44.3% and 41.2% respectively, and the sensitivity was 91.7% ,94.8% respectively with the co-detection of IMA, cTnT or IMA, cTnT and ECG,which was remarkable higher than that any single detection （ P 〈 0. 05 ）. Conclusion IMA is a sensitive biochemical indicator for early ACS, particularly for UA. The coetection of IMA, cTnT and ECG are significant for early ACS.