缺血修饰白蛋白在亚急性心肌梗死延迟PCI治疗中的作用

Plasma Level of Ischemia Modified Albumin before and after Delayed Percutaneous Coronary Intervention in Patients with Subacute Myocardial Infarction

目的观察急性心肌梗死发生后2周进行经皮冠状动脉介入治疗(PCI)前后缺血修饰白蛋白(IMA)以及心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)的浓度变化。方法对62例发病后10～14d的亚急性心肌梗死患者进行冠脉延迟PCI治疗,其中32例为PCI前经冠状动脉造影证实为梗死相关血管已获再通的患者(A组),另30例为梗死相关血管持续完全闭塞的延迟PCI治疗患者(B组),术前、术后0.5、6、12h测两组的血浆IMA、cTnT、CK-MB的水平。结果 A组PCI术后0.5hIMA显著升高,B组IMA在PCI术后无显著变化。结论与cTnT等心肌损伤标志物相比,IMA具有敏感性更高、出现时间更早等优势,检测IMA在亚急性心肌梗死PCI治疗前后有一定的价值。

Objective To investigate changes of plasma level of ischemia modified albumin（IMA）,cTnT and CKMB in patients with subacute myocardial infarction before and after successful coronary artery stent placement.Methods 62 patients with subacute myocardial infarction（10-14days after attack）were divided into two groups according to coronary angiography（CAG）：32 patients with reflowedinfarction relative artery（IRA）,and 30 patients with occluded IRA.All the patients received successful percutaneous coronary intervention（PCI）.The plasma levels of IMA,cTnT and CKMB were measured before,0.5h,6 h,12h after PCI.Results IMA elevated significantly half an hour after PCI in those patients with unoccluded infarction relative artery（IRA）,while no significant changes in those with occluded IRA.Conclusion Compared to the other markers of myocardial injury,IMA has the advantages of higher sensitivity and appear earlier,it has certain value for detecting IMA in subacute myocardial infarction with PCI.