缺血修饰白蛋白与心肌损伤标志物在急性冠脉综合征中的诊断价值

目的研究血清心肌标志物在急性冠脉综合征早期的变化及临床意义。方法分别采用白蛋白钴结合(albumin cobalt binding,ACB)试验、电化学发光法、干式化学法检测急性冠脉综合征(ACS)患者的血清缺血修饰白蛋白(IMA)、肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)。研究对象分为正常对照组59例,心肌缺血组70例,其中急性心肌梗死(AMI)患者38例,不稳定心绞痛(UA)患者32例。结果 (1)AMI、UA组的IMA值与健康对照组比较差异有统计学意义。(2)IMA、CK-MB、cTnT、心电图(ECG)诊断AMI的敏感性为IMA>ECG>CK-MB>cTnT,cTnT动态检测的敏感性明显提高达到61.5%。结论联合检测心肌缺血和心肌坏死的标志物,并根据各项标志物在发病不同阶段的敏感性,能提高ACS患者的诊断效能。

The Diagnosic Value of Ischemia Modified Albumin and Markers of Myocardial Injury in Acute Coronary Syndrome

Objective To research the early changes and clinical values of the Serum Myocardium Markers in Acute Coronary Syndrome（ACS）.Methods The ischemia modified albumin（IMA）,cardiac troponin T（cTnT）,Creatinine kinase isoenzyme MB（CK-MB） in patients with Acute Coronary Syndrome were determined by the experiment of albumin cobalt binding（ACB）,electrogenerated chemiluminescence determination and dry chemical method.Two groups（control group and patients group） were set up in this study.There were 59 healthy subjects in the control group,and 70 patients in the patients group（myocardial ischemia group） in which 38 patients with Acute Myocardial Infarction（AMI） and 32 patients with Unstable Angina（UA） were included.Results（1） IMA level was significantly lower in AMI group and UA group than that in control group（P0.05）.（2） The sensitivity of IMA,CK-MB,and cTnT detection,and the electrocardiogram（ECG） examination to diagnose AMI were IMAECGCK-MBcTnT.Sensitivity of cTnT dynamic detection was obviously increased to 61.5%.Conclusion According to the combined detection of the markers of myocardium Ischemia and myocardial necrosis and the sensitivity of different markers in different stages of the disease,the diagnostic ability for ACS patients can be increased.