探讨缺血修饰清蛋白在ACS早期的诊断意义

Exploring the Clinical Diagnostic Value of Serum Ischemia Modified Albumin in Early Acute Coronary Syndrome

目的缺血修饰清蛋白（ischemia modified albumin，IMA）与传统心肌标志物在急性冠脉综合症（acute coronary syndrome，ACS）早期诊断中的临床应用价值探讨。方法选择因急性胸病就诊的患者47倒，于胸痛4，12，24h连续监潮血清IMA，CK—MB，CTnI水平，另选91例健康体检者作正常对照组，通过绘制IMA在该人群中用于诊断ACS的受试者工作特征（ROC）曲线判定最适截断值（cutoff值），比较IMA与传统心肌标志物在ACS不同时间的阳性率。结果ACS组IMA水平（88．3±17．2U／ml）显著高于健康对照组（61．3±5．4U／ml），t=2．147，P〈0．05；心肌缺血4h以内IMA阳性率（87．2％）明显高于传统心肌标志物（CTnI：8．5％；CK—MB：44．7％），x2=63．2，P〈0．05。结论IMA对ACS患者早期心肌缺血的诊断明显优于传统心肌标志物，而在ACS患者中、晚期意义不大。

Objective To explore the clinical diagnostic value of serum ischemia modified albumin and traditional myocardial biomarker in the early diagnosis of acute coronary syndrome. Methods Detected the level of IMA,CK-MB and CTnI in 47 patients with ACS at 4,12 and 24 hours after chest pain. While another 91 examples with healthy physical examinations were selected to control group. The optimal cut-off value of IMA was ascertained by receiver operating characteristic （ROC） curve of IMA in the diagnosis of ACS. Then compared the positive rate of IMA and traditional myocardial biomarker in the diagnosis of ACS. Results Theserum level of IMA in patients with ACS was significantly higher than which of control group（P〈0. 05）. The positive rate of IMA was significantly higher than which of traditional myocardial biomarker in ACS patients in 4 hours （P〈0. 05）. Conclusion IMA was more beneficial than traditional myocardial biomarker to the diagnosis of early myocardial ischemia in ACS patients,but it was not meaningful to the diagnosis of myocardial ischemia in middle and later period.