血清缺血修饰白蛋白和肌酸激酶同工酶联合检测在急性冠状动脉综合征早期诊断中的价值

目的探讨缺血修饰白蛋白(IMA)和肌酸激酶同工酶(CK-MB)联合检测诊断急性冠状动脉综合征(ACS)的临床价值。方法测定82例ACS患者和80例健康对照者血清IMA及CK-MB浓度。通过ROC曲线分别计算IMA、CK-MB单独和联合诊断ACS的效能。结果 IMA和CK-MB诊断ACS的曲线下面积分别为0.866(95%CI 0.791～0.941)、0.738(95%CI 0.629～0.848)(P<0.01)。IMA和CK-MB联合检测时,截断值(cut-off)取IMA<77.5 U/mL或CK-MB<25 U/L,灵敏度和特异度分别为92.9%和67.0%,阳性预测值和阴性预测值分别为76.4%和89.0%。结论联合检测IMA和CK-MB对ACS的早期诊断具有较高的敏感性和特异性,从而提高ACS的诊断效率。

Value of Combined Detection of Serum Ischemia Modified Albumin and CK-MB in the Early Diagnosis of Acute Coronary Syndrome

Objective To explore the combined detect value of serum ischemia modified albumin(IMA)and creatine kinase isoenzyme-MB(CK-MB)in early diagnosis of acute coronary syndrome(ACS).Methods Serum levels of IMA and CK-MB of 82 hospitalized patients with ACS and 80 healthy people were assayed.ROC curve were established to respectively identify the diagnostic effect of IMA,CK-MB and both combined.Results To identify ACS,the area beneath the ROC curve of IMA and CK-MB was respectively 0.866(95% CI 0.791-0.941)and 0.738(95% CI 0.629-0.848)(P<0.001).When both combined and the cutoff point was defined as 77.5 U/mL of IMA or 25 U/L of CK-MB,the sensitivity and specificity were 92.9% and 67%,the PPV and NPV were 76.4% and 89.0%,respectively.Conclusion Combined detection of serum IMA and CK-MB is more sensitive and specific and more effective in early diagnosis of ACS.