缺血性修饰白蛋白、高敏肌钙蛋白Ⅰ及超敏C反应蛋白在急性冠状动脉综合征早期诊断中的价值  

CLINICAL VALUE OF ISCHEMIA MODIFIED ALBUMIN AND HYPERSENSITIVE TROPONIN I AND HYPERSENSITIVE C-REACTIVE PROTEIN IN EARLY DIAGNOSIS OF ACUTE CORONARY SYNDROME

作　　者：刘首明 夏慧 江小萍 杨莹 王飞马 

机构地区：[1]清远市中医医院,广东清远511500

出　　处：《现代医院》2015年第8期81-83,共3页Modern Hospitals

摘　　要：目的：探讨血清缺血性修饰白蛋白（ IMA）、高敏肌钙蛋白Ⅰ（ hs－cTnI）和超敏C反应蛋白（ hs－CRP）在急性冠状动脉综合征（ ACS）早期诊断中的临床价值，为ACS的诊断提供依据。方法选择2013年3月∽2014年12月收治的胸痛患者98例，按临床诊断分为非缺血性胸痛（ NICP）组35例和 ACS组63例。 ACS组患者中包括不稳定性心绞痛29例（ UA组）、非ST段抬高心肌梗死18例（ NSTEMI组）和ST段抬高心肌梗死16例（ STEMI组）；根据胸痛发作至采血时间窗分为＜3 h组32例和3∽6 h组31例。另选择30名健康体检者作为对照组。比较各组患者 IMA、hs－cTnI、hs－CRP水平变化，评价其对ACS的早期诊断价值。结果 ACS组患者三项指标水平均显著高于NICP组和健康对照组（ p＜0.05）；胸痛＜3 h组和3∽6 h组的IMA显著高于健康对照组（p＜0.05）；胸痛3∽6 h组ACS患者hs－cTnI及hs－CRP水平均高于健康对照组，差异均有统计学意义（p＜0.05）；与胸痛＜3 h组相比，3∽6 h组的IMA水平显著降低（p＜0.05）。结论血清IMA是ACS发病早期心肌缺血的敏感指标，优于hs－cTnI和hs－CRP对ACS发病早期心肌缺血的诊断价值。Objective To study early diagnosis value of the IMA, hs-cTnI, hs-CRP in ACS and provide clinical basis for diagnosis of acute coronary syndrome.Methods Collect the hospital emergency department and heart chest pain patients with 98 ca-ses, 30 health checks for a control.Clinical diagnosis was finally divided into NICP group 35 cases with ACS group 63 cases;Accord-ing to the chest to addiction attack in pursuance of time window , the ACS group is divided into 〈3 h group 32 cases and 3-6 h group of 31 cases, which is divided into UA group of 29 cases.NSTEMI group of 18 patients with STEMI group of 16 cases;patients IMA, hs-cTnI, hs-CRP levels change, specific degrees and accuracy were analyzed.Results The ACS group levels were significantly higher than 3 indexes of NICP group and healthy controls （p〈0.05）; Chest pain 〈3 h and 3-6 h group of IMA was significantly higher than that of healthy controls （p〈0.05）; Chest pain 3 -6 h group hs-CRP and ACS patients serum hs-cTnI levels were higher than healthy controls （p〈0.05）, and the difference was all statistically significant; Compared with chest pain 〈3 h sub-groups, 3-6 h IMA group was significantly lower （p〈0.05）.Conclusion For the serum IMA sensitive indexes of early myocardial ischemia, ACS is better than that of hs-cTnI and hs-CRP in ACS disease role in early diagnosis of myocardial ischemia.

关 键 词：急性冠状动脉综合征 缺血性修饰白蛋白 高敏肌钙蛋白I 超敏C反应蛋白 诊断价值 

分 类 号：R543.3[医药卫生—心血管疾病]