缺血修饰白蛋白在射频消融术前后的变化及其临床意义

Change and clinical significance of ischemia modified albumin in transient myocardial ischemia before and after radio frequency ablation

目的观察心律失常患者射频消融术所诱导的短暂心肌缺血中血清缺血修饰白蛋白、血浆心肌肌钙蛋白T及肌酸激酶同工酶的浓度变化及其临床意义。方法112例行射频消融术的心律失常患者（射频消融组），分别测定术前和术后3、6h血清缺血修饰白蛋白、血浆心肌肌钙蛋白T及肌酸激酶同工酶的浓度，并与91例行冠状动脉造影证实冠状动脉正常患者（对照组）术前和术后3、6h的上述指标的检测结果进行对比分析。结果射频消融组患者的血清缺血修饰白蛋白术后3h[（80．62±7．53）U／ml]、6h[（76．37±9．21）U／ml]较术前[（45．42±7．00）U／ml]升高（P均〈0．05），而对照组患者的缺血修饰白蛋白术前、术后比较差异无统计学意义（P〉0．05）。两组患者血浆心肌肌钙蛋白T及肌酸激酶同工酶术前及术后3、6h差异均无统计学意义（P均〉0．05）。结论缺血修饰白蛋白可在心肌发生缺血缺氧损伤的射频消融术后迅速升高，并早于心肌肌钙蛋白T。缺血修饰白蛋白是早期诊断心肌缺血的敏感生化指标。

Objective To observe the changes and clinical signifieanees of isehemia modified albumin （IMA） , cardiac triponin T （eTnT） and ereatine kinase MB （CK-MB） in transient myocardial ischemia induced by radio frequency ablation （ RFA ） in patients with arrhythmia. Methods One hundred and twelve patients with arrhythmia undergoing RFA and 91 patients undergoing CAG were evaluated with blood levels of IMA, eTnT and CK-MB before and 3 and 6 hours after operation. Results Serum levels of IMA at 3 h [ （80. 62 ± 7. 53 ） U/ml ] and 6 h [ （76. 37± 9. 21 ） U/ml ] after operation rose significantly （ P 〈 0. 05 ） in the 112 cases of RFA compared with the preoperative [ （ 45.42 ± 7. 00 ） U/ml ] . While the levels of IMA were not significantly different at 3 and 6 hours after CAG in the 91 patients compared with before sugery （P 〉0. 05）. The levels of eTnT and CK-MB remained unchanged between the two groups after the procedures （ P 〉 0.05 ）. Conclusion The levels of IMA were quickly increased after myocardial ischemia induced by RFA and this change occurred earlier than that of eTnT. IMA is an early diagnostic biochemical marker of myocardial ischemia.