缺血修饰清蛋白与冠心病相关性研究

The study on the relatioship between on ischemia modified albumin and coronary heart disease

目的评价缺血修饰清蛋白(IMA)在冠心病(CHD)中的诊断价值,并探讨IMA水平与冠脉硬化病变范围的相关性。方法入选冠状动脉造影(CAG)检查确诊的CHD患者88例(CHD组),分为稳定性心绞痛(SA组)16例,急性冠脉综合征(ACS组)72例。再将ACS组分为不稳定性心绞痛(UA组)30例,非ST段抬高型心肌梗死(NSTEMI组)19例,ST段抬高型心肌梗死(STEMT组)23例。根据CAG结果,分为1支血管病变组、2支血管病变组和3支血管病变组。选取同期来该院体检的健康者62例作为对照组。结果 CHD组较对照组IMA明显升高(P<0.05)。ACS组IMA水平明显高于SA组(P<0.05)。NSTEMI组、STEMI组IMA水平高于UA组(P<0.05)。IMA水平和冠状动脉病变支数呈显著正相关(P<0.05,r=0.570)。当受试者工作特征曲线(ROC)的cut-off值确定为80.10U/mL时,曲线下面积为0.869,IMA诊断冠心病的敏感度为65.9%,特异度为98.4%。Logistic回归分析显示,IMA是冠心病的独立预测因子。结论 IMA在CHD诊断中具有较高阴性预测价值,IMA水平和冠状动脉硬化病变范围显著正相关。

Objective To evaluate the value of ischemia modified albumin （IMA） in the diagnosis of coronary heart disease （CHD） and the correlation between IMA levels and the pathological scope of coronary atherosclerosis .Methods A total of 88 coro-nary heart disease（CHD） patients diagnosed by coronary arteriongraphy （CAG） were selected ,including stable angina pectoris （16 cases）（SA group） and acute coronary syndrome （72 cases）（ACS group） .ACS group was further divided into 3 groups ：unstable an-gina pectoris（30 cases）（UA group） ,non-ST-elevation myocardial infarction （19 cases） （NSTEMI group） ,ST-elevation myocardial infarction（23 cases） （STEMI group） .According to the results of CAG ,CHD patients were divided into 3 groups：1 vessel lesion group ,2 vessels lesion group and 3 vessels lesion group ,and 60 healthy physical cases were selected as control group .Results IMA in the CHD group was significantly higher than in control group （P〈0 .05） .IMA in the ACS group was higher than SA group （P〈0 .05） .IMA in the NSTEMI group and STEMI group were significantly higher than UA group （P〈0 .05） .IMA levels and the degree of coronary atherosclerosis were significantly positively correlated （P〈0 .05 ,r=0 .570） .When the cut-off value of IMA was 80 .10 U/mL ,the area under the curve was 0 .869 ,the specificity was 98 .4% and the sensitivity was 65 .9% .Logistic regression a-nalysis showed that IMA was an independent predictor of CHD .Conclusion IMA has a high negative predictive value in the diag-nosis of CHD ,there was a significantly positive correlation between IMA level and the pathological scope of coronary atherosclero-sis .