缺血修饰性蛋白在急性胸痛中的鉴别诊断价值  

作　　者：徐自强[1] 乐东友[1] 黄丽芝[1] 何德剑[1] 廖玉峰[1] 颜复生[1] 

机构地区：[1]湖南省郴州市第一人民医院,423000

出　　处：《大众健康（理论版）》2012年第6期247-248,共2页

摘　　要：目的：探讨即时缺血修饰性白蛋白（IMA）在急性胸痛患者中对缺血性胸痛（ICP）和非缺血性胸痛（NICP）早期鉴别诊断中的价值。方法：利用人血清白蛋白钴结合力（ACB）实验间接测定IMA的方法，对66例急性胸痛的病人在急诊科就诊时即时抽血检测ACB，然后根据出院诊断，甄别出ICP组34例，NICP组32例，并抽血检测30例正常健康人ACB作为对照。结果：ICP组、NICP组和对照组的ACB平均含量分别是44．78±13．79U／mf、68．14±10。15U／ml和69．29±9．84U／ml。ICP组的ACB平均含量与NICP组比较，差异有显著统计学意义（P〈0．001）；ICP组的ACB平均含量与对照组比较差异具有显著统计学意义（P〈0．001）；但NICP组的ACB平均含量与对照组差异比较无统计学意义（P〉0．05）。IMA诊断ICP的敏感性和特异性分别是82．35％和75．00％。阳性预测值是0．78，阴性预测值是0．80。结论：AMI可能是一个有用的早期鉴别急性胸痛的生化标志物。Objective ：To investigate the value of Ischemia modified albumin （IMA） in early differential diagnosis on ischemic chest pain （ICP） and non-ischemic chest pain（NICP）. Methods：Of 66 patients presented Emergency department（ED） with acute chest pain, Point- of-care of IMA levels were measured in the ED by albumin cobalt-binding test（ACB）.34 of 66 patients were enrolled ICP group and 32 cases were enrolled NICP group by the discharge diagnosis, compare with the ACB levels of 30 health adults in control group. Results：The ACB levels were 44.78±13.79U/ml in ICP group, 68.14±10.15 U/ml in NICP group and 69.29±9.84 U/ml in control group,respectively. The ACB levels were significantly higher in ICP group than in NICP group （p〈0.001） ,and were higher than in control group （p〈0.001）,but ACB levels were not significantly increase in NICP group compared with control group （P〉0.05）. Sensitivity ands pecificity of IMA for ICP were, respectively,82.35%and 75.00%.Postive predictive value was 0.78 and negative predictive value was 0.80. Conclusion：IMA may make an differential diagnosis of ICP and NICP. IMA may be a useful biomarker for the early identification of ACS with acute chest pain.

关 键 词：缺血修饰性白蛋白 血清白蛋白钻结合力实验 缺血性胸痛 非缺血性胸痛 急性冠脉综合征 

分 类 号：R446[医药卫生—诊断学]