缺血修饰白蛋白在急性冠状动脉综合征早期诊断中的应用

Role of ischemia modified albumin in early diagnosis of acute coronary syndrome

目的:探讨缺血修饰白蛋白(IMA)在急性冠状动脉综合征(ACS)早期诊断中的价值。方法:采取ACS组56例、非缺血性胸痛(NICP)组30例患者发病3 h内和155名健康体检者(对照组)静脉血,检测并比较3组标本的IMA、MB型肌酸激酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平,应用ROC分析评价各心肌标志物在ACS早期诊断中的效能。结果:3组IMA分别为(0.500±0.017)、(0.400±0.082)、(0.326±0.024)吸光度单位,ACS组与对照组和NICP组比较,IMA水平差异均有统计学意义(P<0.01)。ROC曲线下面积IMA>cTnI>CK-MB,最佳截断点时的灵敏度IMA>CK-MB>cTnI,特异度IMA>cTnI>CK-MB;与NICP组比较,IMA阳性似然比为10.7,阴性似然比为0.008;与对照组比较,IMA阳性似然比8.23,阴性似然比0.013。结论:IMA对ACS早期诊断效能优于cTnI和CK-MB。

Objective：To estimate the value of ischemia modified albumin（IMA） in early diagnosis of acute coronary syndrome（ACS）.Methods：The venous blood samples from 56 patients with ACS（ACS group）,30 patients with non-ischemia chest pain（NICP group） within 3 h of onset and 155 healthy controls were assayed,and the IMA,MB type creatine kinase（CK-MB） and cardiac troponin（cTnI） levels were compared among the three groups.The value of the myocardial markers in early diagnosis of ACS was estimated by the ROC curve.Results：The IMA of the 3 groups were（0.500±0.017）,（0.400±0.082） and（0.326±0.024） absorbance unit,respectively;the serum level of IMA in ACS group was higher than that in healthy controls and NICP group（P0.01）.The area under curve of IMA was larger than that of cTnI and CK-MB;the sensitivity of IMA was higher than that of CK-MB and cTnI;the specificity of IMA was more obvious than that of cTnICK-MB.The best cutoff value of IMA,CK-MB and cTnI was definite.Compared with the NICP group,the positive likelihood ratio and negative likelihood ratio of IMA for ACS were 10.7 and 0.008,respectively;compared with the healthy controls,the positive likelihood ratio and negative likelihood ratio of IMA for ACS were 8.23 and 0.013,respectively.Conclusions：IMA is superior to cTnI and CK-MB in diagnostic of ACS at the early stage.