血清缺血修饰清蛋白在急性冠状动脉综合征危险分层中的价值探讨  

Study on value of serum ischemia modified albumin in risk stratification of acute coronary syndrome

作　　者：陈莉农 刘成桂 黄文方[2] 杨永长[2] 郑伟[3] 

机构地区：[1]成都市妇女儿童中心医院检验科,四川成都610091 [2]四川省医学科学院.四川省人民医院检验科,四川成都610072 [3]四川省医学科学院.四川省人民医院心内科,四川成都610072

出　　处：《国际检验医学杂志》2015年第9期1164-1167,共4页International Journal of Laboratory Medicine

基　　金：国家高技术研究发展计划(863计划)子课题资助项目(2011AA02A111);四川省科技厅科研基金资助项目(2013FZ0080)

摘　　要：目的探讨血清缺血修饰白蛋白(IMA)在急性冠状动脉综合征(ACS)危险分层中的价值。方法用清蛋白-钴结合法检测171例ACS和175例非ACS(NACS)患者血清IMA水平,用受试者工作特征曲线(ROC曲线)评估IMA对ACS危险分层的价值,并建立Logistic回归分析模型。结果 IMA诊断ACS的曲线下面积(AUC)为0.82,最佳cut-off取75.40U/mL时,其诊断ACS的灵敏度、特异度分别为71.8%、74.4%。逐步多元Logistic回归分析显示,在剔除三酰甘油(TG)、血糖(Glu)、同型半胱氨酸(Hcy)、性别、酗酒因素后,IMA是预测ACS的独立变量,其最高三分位数与最低三分位数相比,发生ACS的比值比(OR)为4.17。结论在ACS患者发生阶段,检测IMA可弥补心肌损伤标志物因灵敏度较低的不足,有助于ACS的早期诊断和危险分层。Objective To study the value of serum ischemia modified albumin （IMA） in the risk stratification of acute coronary syndrome （ACS）. Methods The serum IMA level was measured in 171 cases of ACS and 175 cases of non-ACS （NACS） by using the albumin cobalt binding method. The value of IMA in the risk stratification of ACS was evaluated by using the receiver operating characteristic （ROC） curve. The Logistic regression model was established based on the measured data. Results The area under curve （AUC） of IMA for diagnosing ACS was 0.82. When the optimal cut-off value of IMA was defined as 75.40 U/mL,the sensi- tivity and specificity were 71.8% and 74.4G ,respectively. The stepwise multivariate logistic regression analysis demonstrated that IMA was an independent variable for predicting ACS after excluding the factors of triglyceride（TG）, glucose＇（Glu）, homocysteine （Hcy） ,gender and alcoholism,comparing the highest tertiles with lowest tertiles,the odds ratio（OR） for the occurrence of ACS was 4.17. Conclusion In the occurrence period of ACS,detecting serum 1MA level could make up the insufficiency of myocardial injury markers due to the low sensitivity and could be conducive to early diagnosis and risk stratification of ACS.

关 键 词：缺血修饰清蛋白 急性冠状动脉综合征 冠心病 危险分层 微小心肌损伤 

分 类 号：R541.4[医药卫生—心血管疾病] R446.11[医药卫生—内科学]