急性冠脉综合征患者血清中缺血修饰白蛋白检测的研究  

Evaluation of Ischemia Modified Albumin in Serum of Acute Coronary Syndromes

作　　者：徐震[1] 郝天波 吴继华[1] 朱同华[1] 钮丽萍[1] 陆斐斐[1] 沈国荣[1] 

机构地区：[1]南通大学附属吴江医院检验科,江苏吴江215200

出　　处：《标记免疫分析与临床》2016年第4期421-424,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨缺血修饰白蛋白(IMA)在急性冠脉综合征(ACS)早期诊断中的临床应用价值;评价缺血修饰白蛋白与其他心脏标志物在急性冠脉综合征中联合检测的诊断效能。方法采集6小时内持续急性胸痛的患者血清标本163例,采用白蛋白-钴结合试验法(ACB法)检测其缺血修饰白蛋白水平,同时采用化学发光免疫法检测其血清肌钙蛋白I(c Tn I)、肌红蛋白(MYO)水平,采用酶速率法检测肌酸激酶同工酶MB(CK-MB)水平。结果急性冠脉综合征组血清IMA、c Tn I、MYO和CK-MB中位数水平均高于非缺血性胸痛(NICP)对照组(P<0.05)。以血清IMA水平85U/m L、c Tn I水平0.1g/m L、MYO水平65.8ng/m L和CK-MB水平24U/L作为诊断ACS患者和NICP对照者的临界值,ROC曲线下面积分别为0.89、0.83、0.72和0.76。对比IMA、c Tn I、MYO与CK-MB四项指标单独检测,四者联合检测提高了ACS患者的诊断效率。结论 IMA是一种有用的、敏感的早期诊断冠状动脉综合征的心脏生物学标志物。IMA、c Tn I、MYO和CK-MB联合检测能够提高急性冠脉综合征的诊断效率。Objective To explore the diagnostic value of serum Ischemia-modified albumin（ IMA） in patients with acute coronary syndromes（ ACS）. To evaluate the diagnostic efficiency of combined application of IMA and conventional biochemical marker in ACS. Methods Serum samples were collected from 163 consecutive patients with acute chest pain onset within 6 hours. IMA concentrations were measured by the albumin cobalt binding（ ACB） colorimetric assay. Cardiac troponin I（ cTnI） and myoglobin（ MYO） were determined by architect assay,and creatine kinase-MB（ CK-MB） was detected by enzyme reaction rate method. Results The median level serum IMA,cTnI,MYO and CK-MB in ACS were higher than that in NICP（ P〈0. 05）. The diagnostic cut-off values of IMA for c Tn I,MYO and CK-MB were 85U / mL,0. 1g / mL,65. 8ng / mL and 24U/L respectively. The area under the ROC curve（ AUC） for distinguishing ACS patients from NICP controls was 0. 89,0. 83,0. 72 and0. 76,respectively. Compared with the diagnostic efficiency of IMA,c Tn I,MYO or CK-MB alone,combined detection of IMA,c Tn I,MYO and CK-MB improved the diagnostic efficiency of ACS to some extent. Conclusion IMA is a useful,sensitive biochemical marker for the early diagnosis of ACS. Combined with the conventional cardiac marker panel,IMA can improve the diagnostic efficiency for ACS.

关 键 词：急性冠脉综合征 缺血修饰白蛋白 白蛋白-钴结合试验 

分 类 号：R541.4[医药卫生—心血管疾病]