急性脑梗死致心脏损伤患者血清缺血修饰白蛋白的变化

Change of serum ischemia-modified albumin in patients with heart injury caused by acute cerebral infarction

目的:探讨急性脑梗死致心脏损伤患者血清缺血修饰白蛋白的变化。方法:采用白蛋白钴结合试验检测80例单纯性急性脑梗死患者(单纯性脑梗死组)、45例急性脑梗死引起心脏损伤患者(混合性脑梗死组)和759例急性心肌缺血患者(心肌缺血组)血清缺血修饰白蛋白水平,并同时进行心肌肌钙蛋白I和心电图检测。同期检测875例健康体检者(对照组)血清缺血修饰白蛋白。结果:血清缺血修饰白蛋白水平和阳性率在脑梗死组及心肌缺血组均高于正常组(P<0.05),混合性脑梗死组高于单纯性脑梗死组(P<0.05),混合性脑梗死组与心肌缺血组比较差异无统计学意义(P>0.05)。混合性脑梗死组心肌肌钙蛋白I水平高于单纯性脑梗死组(P<0.05)。急性冠状动脉综合征患者首诊缺血修饰白蛋白、心电图、心肌肌钙蛋白I的阳性率分别为80.4%、75.4%和58.7%;缺血修饰白蛋白与心电图或与心肌肌钙蛋白I联合检测,其敏感性分别为93.9%和87.9%。结论:观察脑梗死患者血清缺血修饰白蛋白水平,有助于急性脑梗死所致心脏损伤的早期发现。

Objective To evaluate the change of serum ischemia-modified albumin in patients with heart injury caused by acute cerebral infarction.Methods Cobalt-binding test was used to detect the level of ischemia-modified albumin in 80 patients with simple acute cerebral infarction,45 patients with injured heart caused by acute cerebral infarction and 759 patients with acute myocardial ischemia,meanwhile the cardiac troponin I levels were assayed and ECG was recorded.Other 857 healthy controls were detected the level of ischemia-modified albumin.Results Ischemia-modified albumin levels and their positive rates were higher in patients with acute cerebral infarction and patients with acute myocardial ischemia than those in control group（P0.05）,and were higher in patients with mixed acute cerebral infarction than those in patients with simple acute cerebral infarction（P0.05）.There was no statistic difference between mixed acute cerebral infarction group and myocardial ischemia group（P0.05）.Cardiac troponin I level in patients with mixed acute cerebral infarction was higher than that in simple acute cerebral infarction（P0.05）.In acute coronary syndrome patients,the positive rates of ischemia-modified albumin,electrocardiogram and cardiac troponin I were respectively 80.4%,75.4% and 58.7%.The diagnostic positive rates raised to 93.9% when ischemia-modified albumin was combined with electrocardiogram,and raised to 87.9% when ischemia-modified albumin was combined with cardiac troponin I.Conclusion To observe ischemia-modified albumin levels of patients with mixed acute cerebral infarction can significantly improve the sensitivity in the early diagnosis of myocardial ischemia caused by acute cerebral infarction.