缺血修饰蛋白在急性胸痛患者早期诊断中的临床意义  

Clinical significance of Ischemia Modified Albumin in the Early Diagnosis of Patients with Acute Chest Pain

作　　者：余琦[1] 钮炜西[2] 唐发宽[2] 华宁[2] 林乐健[2] 

机构地区：[1]解放军309医院病理科,北京100091 [2]解放军309医院心内科,北京100091

出　　处：《标记免疫分析与临床》2013年第1期4-7,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨缺血修饰蛋白(IMA)在急性胸痛患者早期诊断中的临床意义。方法急性胸痛患者125例,分为非冠心病组(UCAD)32例,不稳定性心绞痛组(UAP)21例,急性心肌梗死组(AMI)72例。于入院时、末次症状后8h、末次症状后24h抽血,测定血清IMA、cTnI、MYO;采用SPSS13统计软件进行分析。结果结果显示:入院时IMA值在UCAD组、UAP组和AMI组之间比较差异有统计学意义(P<0.05);末次症状后8h,AMI组和IMA值仍与其他两组间比较差异有统计学意义(P<0.05);末次症状后24h,三组患者所测IMA值之间比较差异无统计学意义(P>0.05)。125例患者中,有92例患者诊断为急性冠脉综合症(ACS)。IMA的诊断敏感性最高,为82.6%,ECG仅为29.7%,cTnI为42.8%,MYO为64.3%。不同判断指标的组合在入院后即刻诊断心源性疾病的阳性率为85.2%～93.6%。结论 IMA对急性胸痛患者的早期诊断具有一定的临床意义。Objective To investigate the clinical significance of ischemia modified albumin （IMA） in the diagnosis of patients with acute chest pain. Methods Among the 125 patients with chest pain who were hospitalized in our department, 32 were grouped into non-coronary heart disease （NCAD） group, 21 into unstable angina （UAP） group and 72 into acute myocardial infarction （AMI） group. Blood sample were drown at entry, 8 hours and 24 hours after last attacking, and the levels of IMA, cTnI and MYO were determined. Statistical analysis was done by SPSS 13.0 statistical package. Results The levels of IMA at entry and 8 hour after last attacking in NCAD group were significantly different compared to the other groups （ P 0.05 ） , but the difference was not statistically significant at 24 hour after last attacking （ P 〉 0.05 ）. 92 patients in total 125 patients were diagnosed as the acute coronary syndrome （ACS）. The diagnostic sensitivity of IMA （82.6%） was higher than that of electrocardiogram （29.7）, cTnI （42.8%） and MYO （64.3%）. The heart source disease immediate diagnosis positive rates of different judgment target combinations were from 85.2% to 93.6%. Conclusion IMA might have an important value in the early diagnosis of patients with acute chest pain.

关 键 词：缺血修饰蛋白 心肌酶谱 急性胸痛 肌钙蛋白Ⅰ 肌红蛋白 

分 类 号：R446.1[医药卫生—诊断学]