缺血修饰白蛋白对心肌缺血早期诊断价值的探讨

Research of the Early Diagnostic Value of Ischemia-modified Albumin (IMA) for Myocardial Ischemia

目的探讨缺血修饰白蛋白(IMA)测定在心肌缺血早期的诊断价值。方法采用白蛋白钴结合试验检测83例急症胸痛最终确诊为急性冠状动脉综合征(ACS)的患者和80例健康对照组的IMA水平,并对ACS患者动态观察IMA和临床常用的心肌损伤标志物[肌酸激酶同工酶(CK-MB)和肌钙蛋白T(cTnT)]。结果 ACS患者胸痛发作后2h内血清ACB值为(51.37±7.98)U/mL,明显低于健康对照组(98.43±10.79)U/mL,差异有统计学意义(P<0.05)。83例ACS患者中,胸痛发作2h阳性率达84.3%;而同步测定cTnT阳性率为l6.9%;CK-MB阳性率为14.5%,IMA阳性率与其他两者比较差异有统计学意义(P<0.01)。结论 IMA是ACS的早期敏感指标,是评价早期出现的可逆性心肌缺血的生化标志物。

Objective To investigate the early diagnostic value of ischemia-modified albumin （IMA）for acute myocardial ischemia. Methods We detected IMA levels by albumin cobalt binding（ACB） test of 83 patients with ACS and 80 healthy controls,we observed dynamic changes for the levels of serum IMA and classical cardiac markers [creatine kinase MB（CK-MB）and cardiac troponin T（cTnT）] of patients with ACS. Results ACB value in ACS patients suffering from chest pain within 2 hours was （51.37 ± 7.98）U/mL,it was lower than that in control group （98.43 ±10.79）U/mL（P〈0.05）. The IMA positive rate of ACS patients suffering from chest pain within 2 hour was 84.3% ;Meanwhile,the positive rates with cTnT and CK-MB were 16.9% and 14.5% ,there was a significant difference between IMA, cTnT and CK-MB （P〈O.01）. Conclusion IMA is an early sensitive marker for ACS and an early biochemical marker for evaluating reversible myocardial ischemia.