急性胸痛患者血清缺血修饰白蛋白检测及其意义研究

Application of Ischemia Modified Albumin Inspection in Patients with Acute Chest Pain

【目的】探讨缺血修饰白蛋白（IMA）在急性胸痛患者检测的应用价值。【方法】选取2014年2月至2015年7月本院收治的100例急性胸痛发作3h内胸痛患者，将其分为缺血性胸痛组（59例）和非缺血性胸痛组（41例），缺血性胸痛组进一步分为不稳定型心绞痛组（39例）和急性心肌梗死组（20例）。于入院后即刻、3h、24h分别采集静脉血分离血清，检测肌酸激酶同工酶（cK-MB）、肌钙蛋白I（cTnI）、IMA。【结果】入院后即刻和入院后3h，缺血性胸痛组IMA高于非缺血性胸痛组，差异有统计学意义（P〈0．05）；cTnI、CK-MB水平比较差异无统计学意义（P〉0．05）。入院后24h，缺血性胸痛组IMA与非缺血性胸痛组比较无统计学意义（P〉0．05）；而cTnI和CK-MB均高于非缺血性胸痛组，差异有统计学意义（P〈0．05）。入院后即刻、3h、24h不稳定型心绞痛组和急性心肌梗死组IMA水平比较差异均无统计学意义（P〉0．05）。【结论】IMA是早期诊断非缺血性胸痛和缺血性胸痛的敏感指标，但其并不能诊断区别不稳定型心绞痛和急性心肌梗死。

[Objective]To investigate the application effect of Isehemia Modified Albumin inspection in patients with acute chest pain. [Methods] 100 cases of patients with acute chest pain in 3 h admitted in our hospital from Feb 2014 to July 2015 were selected and divided into ischemie chest pain group （59 eases） and non-isehemic chest pain group （41 cases）. The Ischemic chest pain group was further divided into unstable angina group （39 cases） and acute myocardial infarction group （20 cases）. The venous blood was collected at the instant, 3 h and 24 h after admission. Creatine kinase isoenzyme （CK-MB）, cardiac troponin I （cTnI） and IMA were determined. [Results]At the instant and 3 h after admission, the IMA of the ischemic chest pain group was significantly higher than that of the non-ischemic chest pain group （ P〈0.05）, while there was no significant difference between cTnI and CK-MB level （ P 〉0.05）. At 24 h after admission, there was no significant difference in IMA between the ischemic chest pain group and the non-ischemic chest pain group （ P 〉0.05） ; cTnI and CK-MB of the ischemic chest pain group were significantly higher than those of the non-ischemic chest pain group （ P 〈0.05）. At the instant, 3 h and 24 h after admission , IMA level between the unstable angina group and the acute myocardial infarction group was not statistically significant （ P 〉0.05）. [Conclusion] Ischemia Modified Albumin is a sensitive index for early diagnosing ischemic chest pain and non-ischemic chest pain, but could not diagnose unstable angina and acute myocardial infarction.