缺血修饰性清蛋白和同型半胱氨酸的联合检测在急性冠状动脉综合征诊断中的意义

目的 探讨缺血修饰性清蛋白(IMA)和同型半胱氨酸(Hcy)在急性冠状动脉综合征(ACS)诊断中的应用价值.方法 选择75例ACS患者及同期40例健康体检者,检测IMA和Hcy.IMA的检测采用清蛋白结合(ACB) 试验,Hcy测定采用酶法.计算单项和联检的敏感性和特异性.结果 ACS患者血清 IMA水平(59.1±12.7)U/mL,健康体检者(71.2±7.4)U/mL,ACS患者和健康者两组血清标本的IMA水平比较差异有统计学意义(P<0.01);ACS患者血清Hcy 水平(23.2±13.2)μmol/L,健康体检者(13.7±4.9)μmol/L,ACS确诊患者和健康者两组血清标本的 Hcy水平比较差异有统计学意义(P<0.01);IMA诊断ACS 的敏感度为66.7%,特异度为85.0%,其灵敏度和特异度均高于Hcy(灵敏度65.3%,特异度为55.0%),临床诊断效能高于Hcy.IMA和Hcy两项指标联检诊断ACS敏感性可提高至92.0%,特异性可提高至97.5%.结论 IMA 为一高度敏感的ACS诊断血清学标志物,其与Hcy 联检,有助于ACS的风险评估及早期诊断.

Value of combined detection of IMA and Hcy in diagnosis of acute coronary syndrome

Objective To investigate the application value of ischemia modified albumin(IMA) combined with homocysteine(Hcy) in the diagnosis of acute coronary syndrome(ACS) at an early stage.Methods 75 patients with ACS were enrolled as the ACS group and 40 healthy persons for physical examination were as the control group.IMA and Hcy were detected by the albumin cobalt binding(ACB) test and the enzymatic method respectively.The sensitivity and specificity of single detection and combination detection were calculated.Results The serum ACS levels were(59.1±12.7)U/mL in ACS group and(71.2±7.4)U/mL in the control group with statistical difference between the two groups(P<0.01).The serum Hcy levels were(23.2±13.2)μmol /L in ACS group and(13.7±4.9)μmol/L in the control group with statistical difference between the two groups(P<0.01).The single IMA detection had the sensitivity 66.7% and specificity 85.0% to ACS,the sensitivity and specificity were higher than Hcy′ sensitivity 65.3% and specificity 55.0%,IMA showing higher diagnostic efficiency than Hcy.Furthermore,combined detection of IMA and Hcy could raise the sensitivity to 92.0% and specificity to 97.5%.Conclusion IMA is a highly sensitive serologic marker for ACS diagnosis,and the combined detection of IMA and Hcy can facilitate the ACS risk assessment and early diagnosis.