【摘要】 目的探讨血清缺血修饰白蛋白(IMA)测定对急性心肌缺血的早期诊断价值。方法采用固相酶联免疫吸附试验(ELISA)检测120例健康体检者(健康对照组)、145例急性冠状动脉综合征患者(ACS组)、55例单纯性高血压病患者(高血压组)血清IMA水平,并对其中急性ACS患者同时进行血清肌钙蛋白T(cTnT)检测。通过绘制IMA在该人群中用于诊断ACS的操作者工作特征(ROC)曲线判定最佳临界值,确定IMA诊断ACS的敏感性、特异性、阳性预测值和阴测预测值。结果与健康对照组比较,ACS组IMA水平显著增高(15.12±2.61)ng/L(P<0.01)。根据ROC曲线,当IMA临界值为10.6ng/L时综合评价最佳。IMA检测的敏感度、特异性、阳性预测值和阴性预测值最佳综合评价,分别为82.1%、91.5%、95.6%、93.5%。145例患者中入院1h的IMA测定值超过临界值为119例,阳性率达82.1%;而同步测定cTnT阳性者为59例,阳性率40.6%。IMA阳性率与cTnT比较差异有统计学意义(P<0.01)。结论 IMA是ACS的早期敏感指标,是评价早期出现可逆性心肌缺血的生化标志物。更多还原

【Abstract】 Objective To study the ischemia-modified albumin(IMA)determination of the value of early diagnosis of acute coronary syndrome(ACS).Methods The levels of serum IMA and cardiac troponinT(cTnT)in 145 patients with acute coronary syndrome(ACS)and 120 cases of healthy individuals(healthy control group),55 cases of isolated hypertension(high blood pressure group).The optimal cut-off value of IMA was ascertained by receiver operating(ROC)curve.The sensitivity,specificity,positive and negative predictive values of IMA in the diagnosis of ACS were ascertained.Results The level of IMA in patients with ACS(15.12±2.61)ng/L(P<0.01).According to the ROC curve,when the cut-off value of IMA was 10.6ng/L,the sensitivity,specificity,positive and negative predictive values of IMA were 82.1%,91.5%,95.6% and 93.5% respectively.In 145 patients with ACS,the IMA level of 119 patients at the time of admission had been already above the optimal cut-off value.The positive rate was 82.1%.Meanwhile,the in only 59patients was positive with cTnT.The positive rate was 40.6%.There was significant difference between IMA and cTnT(P<0.01).Conclusion IMA is an early sensitive marker for ACS and an early biochemical mark for evaluating re-versible myocardial ischemia.更多还原