缺血修饰白蛋白与动态心电图联合检查诊断无症状心肌缺血

Ischemia modified albumin test combined with dynamic electrocardiogram tests in the diagnostic of silent myocardial ischemia

目的评价缺血修饰白蛋白(IMA)与动态心电图(DCG)联合检查对无症状心肌缺血的临床诊断价值。方法对106例疑诊冠心病无症状心肌缺血患者进行缺血修饰白蛋白测定及动态心电图检查,并与冠状动脉造影(CAG)检查结果对比分析。结果 106例疑诊患者中,IMA诊断无症状心肌缺血的特异性为72.7%,敏感性为91.9%;DCG诊断无症状心肌缺血的特异性为81.8%,敏感性为83.8%;IMA联合DCG诊断无症状心肌缺血,将其中一项阳性作为诊断参考时,特异性为72.7%,敏感性为96.7%;而将二项指标同时阳性作为诊断参考时,特异性为93.1%、敏感性为85.4%。结论将IMA联合DCG检查结果进行综合分析,既可提高诊断的特异性,也可提高诊断的敏感性,可做为无症状心肌缺血早期发现的重要筛查手段。

Objective The objective of this study is to evaluate the clinical value of ischemia modified albumin （IMA） test combined with dynamic electrocardiogram （DCG） tests in the diagnoses of silent myocardial iscbemia. Methods This study exams 106 patients with clinical suspicion of silent myocardial ischemia by testing IMA combined with DCG and to compare the results with the diagnosis by performing coronary arteriography （CAG）. Results This result shows that,for identifying silent myocardial iscbemia,the diagnostic specificity and sensitivity of testing IMA are 72.7% and 91.9% ,as the diagnostic specificity and sensitivity of performing DCG are 81.8% and 83.8%. The sensi- tivity increases to 96.7% when one positive result shown by testing IMA combining DCG while the specificity is 72. 7%. The diagnostic specificity and sensitivity are 93.1% and 85.4% when both results are positive with IMA combi- ning DCG. Conclusion The diagnostic specificity and sensitivity of silent myocardial ischemia are both increased by in tegrating IMA test with DCG. It therefore fulfills the clinical demand for screening silent myocardial ischemia at its ear- ly stage.