缺血修饰白蛋白在急性冠状动脉综合征中的诊断意义

Evaluation of ischemia modified albumin in the diagnosis of acute coronary syndrome

目的:探讨缺血修饰白蛋白(IMA)对急性冠脉综合征的早期诊断价值。方法:将70例急性冠脉综合征患者分为三组,即不稳定性心绞痛组25例,ST段抬高型心肌梗死组21例,非ST段抬高型心肌梗死组24例,另选70例健康体检者为正常对照组,采用白蛋白钴结合实验(ACB法)检测缺血修饰白蛋白(IMA),同时联合检测肌酸激酶MB同工酶(CK-MB)和肌钙蛋白I(c Tn I),并对检测结果进行分析讨论。结果:急性冠状动脉综合征三组患者中IMA水平均明显高于正常对照组(P<0.01),IMA水平以不稳定性心绞痛组最高。各种心肌酶对诊断急性冠状动脉综合征的敏感度分别为:IMA88%、CK-MB20%、c Tn I42%;CK-MB、c Tn I两者联合检测敏感度为62%;三者联合检测敏感度可达92%。结论:IMA对早期诊断急性冠脉综合征具有重要意义。

Objective To investigate the early diagnostic value of ischemia modified albumin （IMA） in acute coronary syndromes （ACS）. Method The IMA levels were measured by albumin cobalt -binding（ACB） test in the 70 patients with ACS （unstable angina group of 25 cases, ST- elevation myocardial infarction group of 21 cases, non -ST- elevation myocardial infarction group of 24 cases） and 70 healthy controls. And we detected the serum levels of creatine kinase CK - MB isoenzyme （ CK - MB ） and troponin I （cTnI） Results The IMA levels in three groups of acute coronary syndrome were significantly higher than that in the control group （ P 〈 0. 01 ） . The IMA level in the unstable angina group was the highest in three groups of acute coronary syndrome. The sensitivity of various myocardial markers in the diagnosis of acute coronary syndrome were ： IMA 88%, CK - MB 20% and cTnI 42%. The sensitivity of two joint detec- tion,CK - MB,cTnI was 62% and the sensitivity of three joint detection rised up to 92% Conclusion IMA is a useful myocardial marker for the early diagnosis of ACS.