缺血修饰清蛋白对急性心肌梗死危险分层的临床价值研究

Clinical Application of Ischemia Modified Albumin in the Risk Stratification of Acute Myocardial Infarction

目的探讨缺血修饰清蛋白(IMA)对急性心肌梗死危险分层的临床价值。方法通过清蛋白钴结合试验(ACB试验)检测53例急性心肌梗死患者的血清IMA水平(即ACB值),通过随访观察比较IMA与患者心功能、死亡率之间的相关关系。结果心衰组ACB值为(51.49±6.38)U/ml,非心衰组ACB值为(56.16±6.39)U/ml,两组比较差异有统计学意义(P<0.05);ACB值与左室射血分数(LVEF)呈正相关(r=0.619,P<0.001)。死亡组ACB值为(48.47±6.01)U/ml,存活组ACB值为(55.51±6.29)U/ml,两组比较差异有统计学意义(P<0.05)。区分死亡和存活的最适临界值ACB=50.84 U/ml时曲线下面积为0.826,敏感度为78%,特异度为82%。经Logistic回归分析,ACB值降低是死亡事件的独立危险因素(OR=0.724,P=0.046)。结论 IMA水平与LVEF有相关性,IMA可作为急性心肌梗死患者短期死亡事件的独立危险因素。

Objective To explore the clinical values of ischemia modified albumin（IMA） in the risk stratification of acute myocardial infarction（AMI）.Methods IMA levels（ACB value） were detected using albumin cobalt binding（ACB） test in 53 patients with acute myocardial infarction and correlations between IMA and cardiac function and mortality were analyzed via subsequent follow-up.Results ACB values was（51.49±6.38） U/ml in the acute heart failure group and was（56.16±6.39）U/ml in the non-heart failure group（P0.05）.ACB value was positively correlated with LVEF by Pearson related test（r=0.619,P0.001）.ACB values of the death group was（48.47±6.01） U/ml and ACB values of the survival group was（55.51±6.29） U/ml,with significant difference between the two groups（P0.05）.A cutoff value for discriminating death and survival（ACB=50.84U/ml） corresponded with an area under the ROC curve of 0.826,a sensitivity of 78% and a specificity of 82%.The decrease of ACB value was an independent risk factor for cardiac death events according to logistic regression analysis（OR=0.724,P=0.046）.Conclusion The level of IMA might be correlated to LVEF.IMA can be used as an independent risk factor for short-term death of AMI patients.