缺血修饰白蛋白检测对急性冠脉综合征的诊断价值

Dignostic value of the detection of ischemia modified albumin for acute coronary syndrome

目的：探讨血清缺血修饰白蛋白（ IMA）检测对急性冠脉综合征（ ACS）的早期诊断意义。方法采用白蛋白钴结合试验检测97例疑似ACS 患者（观察组）3 h内血清标本，间接测定白蛋白与钴离子的结合能力（ ACB）来测定IMA，采用免疫抑制法检测肌酸激酶、肌酸激酶同功酶，化学发光法检测肌红蛋白、肌钙蛋白Ⅰ，观察它们的变化水平，同时对59例健康体检者（对照组）检测IMA水平。结果观察组ACB （53.55±8．23）U/mL，明显低于对照组的（78．00±6．35） U/mL（ t＝34．51，P＜0．01）；观察组IMA 阳性率84.8％，均明显高于其他四种心肌标志物（肌酸激酶、肌酸激酶同功酶、肌红蛋白、肌钙蛋白Ⅰ）（χ^2＝17．34、15.21、13．34、13．38，均P＜0．01）。结论对ACS患者进行IMA检测，可做到早期诊断，值得临床推广应用。

Objective To expore the early diagnostic value of the detection of serum ischemia modified albu-min（ IMA） for acute coronary syndrome （ ACS） .Methods Albumin cobalt binding assay was used to detect the ser-um samples in 97 cases of suspected ACS （ the observation group ） within three hours ,and IMA was determined by in-direct determination of the binding capacity of albumin and cobalt ions .Immunosuppressive assay was used to detect CK and CKMB.The levels of MYO and troponin Ⅰwere observed by chemiluminescence assay .Meanwhile,the IMA level in 59 healthy subjects （ the control group ） was detected.Results The ACB of the observation group was （53.55 ±8.23）U/mL,which was lower than （78.00 ±6.35）U/mL of the control group（t=34.51,P〈0.01）.The positive rate of IMA in the observation group was 84.8%,which was significantly higher than the positive rate of CK , CK-MB,MYO,CTnI（χ^2 =17.34,15.21,13.34,13.38,all P〈0.01）.Conclusion IMA detection in patients with ACS can help early diagnosis ,which is worthy of clinical popularization and application .