摘要
目的探讨缺血修饰白蛋白（IMA）对急性心肌梗死（AMI）的早期诊断价值。方法103例胸痛发作患者分别于入院即刻及4、6、12、24h连续监测IMA、肌钙蛋白I（cTnI）、肌酸激酶同工酶MB（CK-MB）三项指标，观察其变化规律，同时选择30例健康对照进行检测。结果23例患者最终诊断为AMI；入院即刻IMA、CK-MB、cTnI检测的敏感性、特异性分别为IMA89．3％、91．3％，CK-MB48．4％、92．3％，cTnI30．6％、93．7％；2k院6h内，IMA、CK—MB、cTnI的敏感性分别为91．3％、34．8％、52．2％，联合检测敏感性为100．0％，三者比较差异有统计学意义（χ2=15．99，P〈0．01）。结论IMA对AMI的早期诊断有较高的价值，IMA联合cTnI、CK-MB检测诊断AMI，其敏感性明显优于单项检测，具有重要的临床应用价值。
Objective To investigate the value of ischemia modified albumin （IMA） detection in preliminary diagnosis of acute myocardial infarction （AMI）. Methods The levels and variations of IMA, cTnI and CK-MB in 103 patients with acute chest pain were measured continuously at 0,4,6, 12,24 hours after admission respectively. Thirty healthy subjects were observed as normal controls. Results Twenty three patients were diagnosed as AMI in the end, the sensitivity and specificity rates fight after admission were 89. 3% and 91.3% for IMA, 48.4% and 92. 3% for CK-MB, 30. 6% and 93.7% for cTnI respectively. The sensitivity values at the 6th hours after admission were 91.3% for IMA, 52. 2% for CTnI and 34. 8% for CK-MB respectively. The specificity was 100.0% when the IMA was detected in combination with CK-MB or cTnI. The sensitivity of co-detection was significandy higher than that any single detection at sixth hours after admission （ X2 = 15.99,P 〈 0. 01 ）. Conclusion Plasma IMA assessment is helpful for early diagnosis of AMI, and will significantly improve the sensitivity early diagnosis of AMI. The co-detection of IMA and CK-MB or eTnI obviously surpasses any single detection, and has extremely vital clinical significance.
出处
《中国综合临床》
2011年第10期1012-1014,共3页
Clinical Medicine of China
基金
上海市卫生局科研基金
关键词
缺血修饰白蛋白
急性心肌梗死
Ischemia modified albumin
Acute myocardial infarction
