缺血性修饰白蛋白在不稳定型心绞痛患者中的早期诊断价值

Earlier diagnostic value of ischemia-modified albumin in unstable angina pectoris patients

目的观察缺血性修饰白蛋白（ischemiamodified albumin，IMA）在不稳定型心绞痛（unstable angina pectoris，UAP）患者中的早期诊断价值。方法对UAP住院且在住院期间再次出现胸痛发作的72例患者，根据胸痛发作10分钟内心电图与症状未发作时心电图有无变化分为：心电图有变化组（39例）和心电图无变化组（33例），所有患者均于胸痛发作30分钟，2、4、6小时采血检测IMA；分析IMA值随时间的变化及两组间是否存在差异。结果IMA在UAP患者胸痛发作30分钟即升高，2～4小时达到高峰，于6小时明显下降（但仍偏高），与健康对照者比较差异有统计学意义（P〈0．01）。UAP患者心电图有变化组与无变化组在胸痛发作后IMA值变化趋势相同，心电图有变化组与无变化组间IMA值差异无统计学意义（P〉0．05）；两组胸痛发作30分钟，2、4、6小时不同时点IMA值比较：心电图有变化组分别为（58．69±5．50）kU／L、（69．17±4．45）kU／L、（68．03±4．22）kU／L、（56．06±5．84）kU／L，心电图无变化组分别为（58．07±5．38）kU／L、（67．87±4．13）kU／L、（66．51±3．88）kU／I。（55．00±4．56）kU／L，其差异有统计学意义（P〈0．01）；两组组间与不同时点无交互作用（P〉0．05）。结论IMA可作为诊断UAP早期的一个心肌标志物，且在心电图无特异性变化的患者中诊断价值更大。

Objective To investigate the earlier diagnostic value of ischemia-modified albumin（IMA） in unstable angina pectoris patients. Methods The study enrolled 72 cases of unstable angina pectoris patients who were in hospital,and whose onset broke out once again in hospital time. According to electrocardiogram（ECG） change or not in the 10 min of chest pain,the patients were divided into ECG changed group （39 cases） and unchanged group （33 cases） ,All patients＇ blood samples were collected to test IMA in 30 min,2 h,4 h,6 h. The change of IMA by the time change and difference between the two groups were analyzed. Results IMA began to rise after 30 min of the onset,and reached a high peak at 2--4 h,and descended obviously at 6 h, but also high, and had statistical significance compared with that of the healthy group （ P 〈 0.01）. The tide of variation was the same between ECG changed group and unchanged group, and had no statistical significance between two groups（ P 〉0.05）. Comparing IMA of two groups at different time points of chest pain 30 rain, 2 h, 4 h, 6 h, ECG changed group respectively was （58.69 ± 5.50） kU/L, （69.17±4.45） kU/L,（68.03±4.22） kU/L,（56.06±5.84） kU/L,ECG unchanged group （58.07±5.38） kU/L, （67.87±4.13） kU/L,（66. 51±3. 88） kU/I., （55.00±4.56） kU/L,and the difference had statistical significance （ P 〈 0.01） ,and there were no interaction between the time points and groups（ P 〉0.05）. Conclusion IMA would be an earlier biomarker for the unstable angina pectoris patients,and has the greatest diagnostic value in normal ECG.