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急性冠状动脉综合征血清缺血修饰白蛋白的动态变化
引用本文:陈建军,李向平.急性冠状动脉综合征血清缺血修饰白蛋白的动态变化[J].中国循环杂志,2007,22(1):13-16.
作者姓名:陈建军  李向平
作者单位:410011,湖南省长沙市,中南大学湘雅二医院,心内科
摘    要:目的:探讨血清缺血修饰白蛋白(IMA)对急性冠状动脉综合征早期的诊断价值。方法:将56例急性冠状动脉综合征患者分为三组,不稳定性心绞痛组(n=25),ST抬高心肌梗死组(n=20),非ST抬高心肌梗死组(n=11),另选50例健康体检者为正常对照组。分别于胸痛发作2、4、6、12及24 h抽血检测56例急性冠状动脉综合征患者的血清缺血修饰白蛋白、肌钙蛋白Ⅰ(cTnI)、肌酸激酶MB同工酶(CK-MB),分析缺血修饰白蛋白对急性冠状动脉综合征的诊断价值。结果:在急性冠状动脉综合征患者中缺血修饰白蛋白水平于胸痛发作2小时已明显增高并达高峰,4小时仍持续增高,明显高于正常对照组(P<0.01),6小时降至正常。而CK-MB、cTnI水平在胸痛发作4小时开始增高,6小时明显增高,以后逐步递增并在24小时达高峰。不稳定型心绞痛、ST抬高的心肌梗死、非ST抬高的心肌梗死三组中,缺血修饰白蛋白水平升高以不稳定型心绞痛组最明显。结论:缺血修饰白蛋白是诊断急性冠状动脉综合征的早期敏感指标,是目前唯一的诊断心肌缺血的生化标志物。

关 键 词:急性冠状动脉综合征  缺血修饰白蛋白  肌钙蛋白  Ⅰ肌酸激酶MB同工酶
文章编号:1000-3614(2007)01-0013-04

Dynamic Variations of the Ischemia Modified Albumin in Patients With Acute Coronary Syndromes
CHEN Jian-jun,LI Xiang-ping.Dynamic Variations of the Ischemia Modified Albumin in Patients With Acute Coronary Syndromes[J].Chinese Circulation Journal,2007,22(1):13-16.
Authors:CHEN Jian-jun  LI Xiang-ping
Abstract:Objective:To investigate the diagnosis value and significance of the ischemia modified albumin in actue coronary syndromes (ACS). Methods:The serum concentrations of IMA, CK-MB and cTnI were collected in 56 patients with ACS at 2,4, 6, 12 and 24 hours after chest pain onset to evaluate role of IMA in the early diagnosis of ACS. Results: Serum levels of IMA were obviously elevated and reached peak at 2 hours and even higher at 4 hours after chest pain onset. IMA levels returned to normal at 6 hours. Serum levels of IMA were obviously than the normal control group. Serum levels of CK-MB and cTnI started to elevate at 4 hours and obviously at 6 hours after chest pain onset. Campared with the non-ST-elevation myocardial infarction group and ST-elevation myocardial infarction group, the elevation of serum levels of IMA was more significant in the unstable angina group. The serum levels of CK-MB and cTnI had no significant variation. Conclusion: The levels of IMA could be recommend as a sensitivity index in the early diagnosis of ACS. IMA is unique biochemical marker in the diagnosis of myocardial ischaemia.
Keywords:Acute coronary syndromes  Ischemia modified albumin  Cardiac troponin I  Creatine kinase MB
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