缺血修饰白蛋白在急性肺栓塞诊断中的作用

The application of ischemia modified albumin in the diagnosis of acute pulmonary embolism

目的:探讨血浆缺血修饰白蛋白对急性肺栓塞(APE)的诊断价值。方法:检测39例确诊为APE患者及对照组30例健康受试者血浆缺血修饰白蛋白(IMA)、D-二聚体含量,利用ROC曲线分析并比较IMA、D-二聚体对APE的诊断价值。结果:APE组患者血浆IMA(75.84±15.70U/ml)、D-二聚体(5.41±5.29mg/L)较对照组明显增高(P<0.01),根据ROC曲线,IMA最佳界值为63.30U/ml,此时诊断APE的敏感性为87.2%,特异性为80%。D-二聚体最佳界值为0.57mg/L,此时诊断APE的敏感性为94.9%,特异性为66.7%。联合IMA、D-二聚体可提高诊断APE的特异性至90%(P<0.05)。IMA在APE高危、中危、低危各亚组之间差异有统计学意(P<0.05或0.01)。结论:IMA可用为APE的诊断标志物,检测IMA水平有助于APE的危险分层。

Objective：To estimate the value of ischemia modified albumin（IMA）in the diagnosis of acute pulmonary embolism（APE）.Method：The levels of plasmid IMA and D-Dimer in 39patients with APE and 30healthy controls were measured.The cut-off values of IMA and D-Dimer in the diagnosis of APE were established with ROC Curves.Result：The levels of IMA（[75.84±15.70]U/ml）and D-Dimer（[5.41±5.29]mg/l）in patients with APE were significantly higher than that in healthy controls（P0.01）.According to the ROC curve,the most appropriate IMA cut-off value in APE was 63.30U/ml（with sensitivity 87.2%,specificity 80%）.The most appropriate D-Dimer cut-off value in APE was 0.57mg/L（with sensitivity 94.9%,specificity 66.7%）.The use of IMA in combination with D-Dimer have a positive impact on the specificity value（P0.05）.The level of plasmid IMA in high risk group of APE was higher significantly than that in medium or low risk groups（P 0.05）.Conclusion：IMA can be used in diagnosis and evaluation the risk stratification of acute pulmonary embolism.