冠心病患者血清缺血修饰白蛋白的水平变化及临床意义

Changes and clinical significance of serum ischemia-modified albumin in patients with coronary heart disease

目的观察冠状动脉粥样硬化性心脏病(冠心病,CHD)患者血清缺血修饰白蛋白(IMA)水平变化及临床意义。方法选择2018年1月至2020年1月在本院就诊的CHD患者80例为观察组,另选取同时期健康体检者60例为对照组,其中观察组患者中无症状心肌缺血(SMI)组14例,心绞痛(AP)组28例,心肌梗死(AMI)组27例和缺血性心肌病(ICM)组11例。根据冠状动脉造影术(CAG)不同病变血管数目,将观察组患者分为单支病变组38例、两支病变组29例和三支病变组13例。对比各组血清超敏肌钙蛋白T(hs-cTnT)、肌酸激酶同工酶(CK-MB)、超敏C-反应蛋白(hs-CRP)和IMA水平。采用Pearson法分析IMA水平与其他指标间的相关性。结果观察组入院时hs-cTnT、hs-CRP、CK-MB和IMA均较对照组升高(P<0.05),治疗后24 h时hs-cTnT、hs-CRP和IMA较入院降低,且以治疗后72 h时降低明显(P<0.05),治疗后24 h时CK-MB水平升高(P<0.05),72 h时降低(P<0.05);AP组、AMI组和ICM组血清hs-cTnT、hs-CRP、CK-MB和IMA水平较SMI组升高(P<0.05);AMI组CK-MB和IMA水平较其余组升高明显(P<0.05);与单支病变组比较,两支病变组和三支病变组血清hs-cTnT、hs-CRP、CK-MB和IMA水平均升高(P<0.05);与两支病变组比较,三支病变组CK-MB、IMA水平升高(P<0.05)。相关性分析显示,血清IMA与hs-cTnT、hs-CRP、CK-MB均呈正相关(r=0.554、0.541、0.521,P<0.05)。结论 CHD血清IMA异常升高,与患者心肌细胞损伤及炎性反应密切相关,检测血清IMA水平有利于CHD早期诊断和病情评估。

Objective To observe the changes and clinical significance of serum ischemia-modified albumin(IMA)level in patients with coronary atherosclerotic heart disease(CHD).Methods 80 patients admitted in our hospital from January 2018 to January 2020 were selected as observation group,and 60 healthy controls were selected as control group.In the observation group,there were 14 patients with silent myocardial ischemia(SMI),28 patients with angina pectoris(AP),27 patients with myocardial infarction(AMI)and 11 patients with ischemic cardiomyopathy(ICM).According to the number o£different pathological vessels in coronary angiography(CAG),the patients in the observation group were divided into single vessel group(38 cases),two vessels group(29 cases)and three vessels group(13 cases).The serum level of high-sensitivity cardiac troponin T(hs-cTnT),creatine kinase isoenzyme(CK-MB),high sensitivity C-reactive protein(hs-CRP)and IMA among groups was compared.Pearson method was used to analyze the correlation between IMA level and other indicators.Results The levels of hs-cTnT,hs-CRP,CK-MB and IMA in the observation group were higher than those in the control group(P<0.05).The levels of hs-cTnT,hs-CRP and IMA were significantly lower at 24 hours after treatment than those at admission;at 72 hours after treatment,the above indexes level was significantly lower(P<0.05).The level of CK-MB increased 24 hours after treatment(P<0.05),and decreased 72 hours after treatment(P V0.05).The levels of hs-cTnT,hs-CRP,CK-MB and IMA in AP group,AMI group and ICM group were higher than those in SMI group(P<0.05).The levels of CK-MB and IMA in AMI group were significantly higher than those in other groups(P<0.05).The levels o£hs-cTnT,hs-CRP,CK-MB and IMA were higher in the two vesseis group and three vessels group than in the single vessel group(P<0.05).The levels of CK-MB and IMA in the three vessels group were higher than those in the two vessels group(P<0.05).The correlation analysis showed that serum IMA was positively correlated with hs-cTnT,hs-CRP and CK-MB(r=0.554,0.541,0.521,P<0.05).Conclusions The abnormal increase of serum IMA in CHD is closely related to myocardial cell injury and inflammatory response.The detection of serum IMA level is conducive to the early diagnosis and condition evaluation of CHD.