血清缺血修饰白蛋白在急性冠状动脉综合征诊断中的应用价值研究

Study on the Application of Serum Ischemia Modified Albumin in Diagnosis of Acute Coronary Syndrome

目的探讨血清缺血修饰白蛋白(IMA)在诊断急性冠状动脉综合征中的应用价值。方法随机选取2014年至2015年因怀疑急性冠状动脉综合征而收治入河南大学第一附属医院心内科且拟行冠状动脉造影术的患者100例。行造影前均接受IMA、肌钙蛋白(cTnT)、血脂、血压及心电图(ECG)检测;以造影结果为标准将入组患者分为冠心病组和非冠心病组。分析IMA对冠心病心肌缺血诊断的价值,诊断价值采用受试者工作特征曲线(ROC曲线)下面积(AUC)以及logistic回归分析。结果冠心病组患者的平均IMA水平[(91±27)U/m L]较非冠心病组患者的平均IMA水平[(59±21)U/m L]明显升高。当Cut-off值为77.53 U/m L时,其诊断冠心病心肌缺血的价值最大,敏感度、特异度、阳性预测值、阴性预测值分别为88.1%、36.4%、74.7%、57.1%。而同步测定cTnT真阳性者为39例,敏感度为58.2%。结论 IMA是诊断急性冠状动脉综合征的早期敏感指标。

Objective To investigate the application value of serum ischemia modified albumin （IMA） in diagnosis of acute coronary syndrome. Methods Randomly selected 100 cases of patients undergoing coronary angiography of suspicion of acute coronary syndrome and admitted to the deparlment of cardiology, the First Affiliated Hospital of Henan University in 2014-2015 years. IMA, troponin （cTnT）, blood lipid, blood pressure and electrocardiogram （ECG） were detected before angiography. The patients were divided into the coronary heart disease group and the non CHD group by the results of the angiography. To analyze the value of IMA in the diagnosis of myocardial ischernia in patients with coronary heart disease, the diagnostic value was analyzed by the area （AUC） of ROC curve and Logistic regression analysis. Results The level of IMA in palients with CHD[（97±27）U/mL] was significantly higher than that in non CHD[（59±21 ）U/roLl controls. When the cut-off value of IMA was77.53 U/mL,the sensitivity, specificity and both positive and negative predictive values of IMA were 88.1%, 36.4%, 74.7% and 57.1% respectively. The value oflMA in diagnosis of coronary heart disease myocardial ischemia is the largest, the sensitivity rate was 58.2%. Meanwhile, the value in only 39 patients was positive with cTnT. Conclusions IMA is an early sensitive index for diagnosis of acute coronary syndrome（ACS）.