【摘要】 目的探讨缺血修饰白蛋白(IMA)测定在急性心肌缺血早期诊断中的应用价值。方法应用白蛋白-钴离子结合实验检测40例急性心肌梗死(AMI)患者、342例不稳定心绞痛(UA)患者、71例陈旧性心肌梗死(EMI)患者、60例非心源性胸痛(NICP)患者的血清IMA和肌钙蛋白(c Tn T)水平。比较各组患者胸痛发作后3 h内血清IMA水平;应用ROC曲线获得识别急性心肌缺血的最佳IMA水平的截断值。结果 AMI患者血清IMA水平为(82.83±9.60)U/ml,显著高于NICP组(73.80±9.25)U/ml和对照组(69.02±3.92)U/ml,P<0.01;UA患者血清IMA水平为(81.57±10.25)U/ml,与AMI患者比较差异无统计学意义(P>0.05),应用ROC曲线分析得出识别急性心肌缺血的IMA截断值为72.1 U/ml,以此值诊断急性心肌缺血的敏感度为92.6%,特异性为69.0%;联合应用IMA和c Tn T诊断急性心肌缺血的敏感度为97.2%,特异性为73.3%。结论 IMA是急性心肌缺血早期诊断的敏感指标,与c Tn T联合诊断可提高早期发现急性心肌缺血的敏感度。更多还原

【Abstract】 Objective To discuss the value of isehemia mollified albumin( IMA) in the early diagnosis of acute myocardial ischemia. Methods IMA and c Tn T level was studied in 40 acute myocardial infarction( AMI) patients,342 unstable angina(UA) patients,71 old myocardial infarction(OMI) patients,and 60 nonischemic ochest pain(NICP) patients. Serum IMA level in groups were compared after the onset of chest pain in 3 h; application of ROC curves was conducted to obtained the best truncated values of IMA levels for recognition of acute myocardial ischemia. Results Serum IMA level in patients with AMI(82. 83 + 9. 60) U/ml,was significantly higher than that of group NICP(73. 80 + 9. 25) U/ml and the control group(69. 02 +3. 92) U / ml,P < 0. 01; Serum IMA levels in patients with UA(81. 57 + 10. 25) U / ml,difference had no statistical significance compared with AMI patients( P > 0. 05),the application of ROC curve was used to analyze that recognition of acute myocardial ischemia IMA cutoff value of 72. 1 U / ml,with this value sensitivity in diagnosis of acute myocardial ischemia was92. 6%,the specificity was 69%; The sensitivity of the combined application of IMA and c Tn T in the diagnosis of acute myocardial ischemia was 97. 2%,the specificity was 73. 3%. Conclusion Serum IMA level is a sensitive marker in the early diagnosis of acute myocardial ischemia,and the combined diagnosis with c Tn T can increase the sensitivity of finding AMI.更多还原