血清缺血修饰白蛋白在心肌缺血早期诊断中的意义及与冠脉造影结果相关性分析

Research on the value of serum IMA in the diagnosis of early ischemia myocardial and the correlation with coronary angiography results

目的探讨IMA与冠状动脉狭窄程度的相关性,分析IMA在冠心病患者心肌缺血早期诊断中的意义。方法收集183例经双源CT(dual source CT,DSCT)证实为冠状动脉粥样硬化患者样本,检测血清IMA、MPO、H-FABP及各项心肌标志物水平,并分析与病变冠脉支数和冠脉狭窄程度的相关性。同时收集经DSCT证实无冠脉狭窄者为正常对照组。结果 (1)与对照组相比,冠心病组血清IMA、MPO、H-FABP水平均显著升高(P<0.05)。(2)血清IMA水平在二支病变组、三支病变组均明显高于单支血管病变组(P<0.05);二支病变组与三支病变组之间无显著差异。而血清MPO、H-FABP水平在不同冠脉病变支数组间差异无统计学意义。(3)血清IMA水平在冠心病冠脉病变轻度、中度、重度狭窄组差异均有统计学意义(P<0.01),且与狭窄程度呈正相关。结论 IMA水平与冠状动脉病变血管的数目和狭窄程度具有很好的相关性,为冠心病患者经皮冠状动脉介入治疗术前筛查提供实验指标,有望成为冠心病心肌缺血早期诊断血清标志物。

Objective To investigate the correlation between the level of serum IMA and the degree of coronary artery stenosis,and analyze the diagnostic value of IMA in early ischemia myocardial of chronic coronary heart disease. Methods Collected specimen from 183 coronary atherosclerosis patients diagnosed with dual source CT（ DSCT）,detected the levels of serum IMA,MPO,H- FABP and other all cardiac markers,and analyzed the correlation with the quantity of pathology changed coronary and the degree of coronary artery stenosis. At the same time,collected those who were confirmed without coronary artery stenosis by DSCT ad the control group. Results（ 1） The levels of IMA,MPO and H- FABP in coronary heart disease group were significantly higher than those in control group（ P 〈 0. 05）.（ 2） The levels of IMA was significantly higher in groups of two and three coronary branches stenosis than in the single one（ P 〈 0. 05）; but there was no obvious difference between groups of two and three coronary branches stenosis. Also levels of serum MPO and H- FABP in different groups of stenodis coronary with different quantities had no obvious difference.（ 3） The result shows that in groups with different degrees of stenosis of coronary,there was significant difference of IMA level among the mild,moderate and severe groups（ P 〈 0. 01）,and the difference was positively related to the degree of stenosis. Conclusion The level of IMA was closely related to the quantity and the degree of stenosis of coronary artery. Therefore,IMA can be used as a biochemical marker of patients with percutaneous coronary intervention before operation,and could be an useful diagnostic marker in early ischemia myocardial of chronic coronary heart disease patients.