IMA在急性冠状动脉综合征中的诊断意义  

Diagnosis Significance of IMA in Acute Coronary Syndrome

作　　者：王伟[1] 罗蓉[1] 陈金玲[1] 李卓成[1] 陈剑雄[1] 

机构地区：[1]深圳市第二人民医院检验科,广东深圳518035

出　　处：《深圳中西医结合杂志》2009年第4期220-223,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：深圳市科技计划项目(200703168)

摘　　要：目的:探讨ACB法检测急性冠脉综合征患者血清中IMA水平及联合检测IMA、CK、CK-MB、cTnI、LDH水平的诊断价值。方法:将80例急性冠脉综合征患者分为3组,不稳定性心绞痛组27例,ST段抬高型心肌梗死组25例,非ST段抬高型心肌梗死组28例,另选150例健康体检者为正常对照组,抽血检测其缺血修饰白蛋白(IMA)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、乳酸脱氢酶(LDH),对检测结果进行分析讨论。结果:急性冠状动脉综合征3组患者中IMA水平均明显高于正常对照组(P<0.01),IMA水平以不稳定性心绞痛组最高。各种心肌酶对诊断急性冠状动脉综合征的敏感性分别为:IMA88%、CK22%、CK-MB20%、cTni32%、LDH28%;CK、CK-MB、cTnI、LDH,四者联合检测敏感性为52%;五者联合检测敏感性可达92%。结论:IMA在早期诊断急性冠脉综合征中具有临床应用价值。ACB法检测IMA对急性冠脉综合征的诊断明显优于其他传统酶类,联合检测则大大提高了急性冠脉综合征的确诊率,减少漏诊和误诊的发生。Objective To evaluate the diagnostic value of ischemic modified albumin levels in patients with acute coronary syndrome and joint detection of IMA, CK, CK-MB, cTnI, LDH levels. Methods Serum levels of ischemia-modified albumin（IMA）, creatine kinase（CK）,CK-MB isoenzyme（CK-MB）, troponin I（cTnI）, lactic acid dehydrogenase（LDH） were determined with auto-biochemical analyzer and analyzed statistically in 80 patients with acute coronary syndrome and 150 healthy subjects. Results The serum level of IMA was significantly higher in patients with Acute coronary syndrome than the normal control group （P 〈 0.01）,the highest in patients with unstable angina group.Various myocardial enzymes in the diagnosis of the sensitivity of acute coronary syndrome were： IMA88%, CK22%, CK-MB20%, cTnI32%, LDH28%; CK, CK-MB, cTnI, LDH, four joint detection sensitivity was 52%; five joint detection sensitivity up to 92%. Conclusion IMA is the more useful biochemical marker for early diagnosis of ACS than other traditional enzymes. It will improve the early diagnostic sensitivity of ACS significantly and reduce the incidence of misdiagnosis and missed diagnosis.

关 键 词：急性冠状动脉综合征 缺血修饰白蛋白 心肌缺血 

分 类 号：R541.4[医药卫生—心血管疾病]