急性胸痛患者血清缺血修饰白蛋白检测及其意义研究

【目的】探讨缺血修饰白蛋白(IMA)在急性胸痛患者检测的应用价值。【方法】选取2014年2月至2015年7月本院收治的100例急性胸痛发作3 h 内胸痛患者,将其分为缺血性胸痛组(59例)和非缺血性胸痛组(41例),缺血性胸痛组进一步分为不稳定型心绞痛组(39例)和急性心肌梗死组(20例)。于入院后即刻、3 h、24 h 分别采集静脉血分离血清,检测肌酸激酶同工酶(CK-MB)、肌钙蛋白 I(cTnI)、IMA。【结果】入院后即刻和入院后3 h,缺血性胸痛组 IMA 高于非缺血性胸痛组,差异有统计学意义(P <0.05)；cTnI 、CK-MB 水平比较差异无统计学意义(P >0.05)。入院后24 h,缺血性胸痛组 IMA 与非缺血性胸痛组比较无统计学意义(P >0.05)；而 cTnI 和 CK-MB 均高于非缺血性胸痛组,差异有统计学意义(P <0.05)。入院后即刻、3 h、24 h 不稳定型心绞痛组和急性心肌梗死组IMA 水平比较差异均无统计学意义(P >0.05)。【结论】IMA 是早期诊断非缺血性胸痛和缺血性胸痛的敏感指标,但其并不能诊断区别不稳定型心绞痛和急性心肌梗死。

Application of Ischemia Modified Albumin Inspection in Patients with Acute Chest Pain

Objective]To investigate the application effect of Ischemia Modified Albumin inspection in patients with acute chest pain.Methods]100 cases of patients with acute chest pain in 3 h admitted in our hospital from Feb 2014 to July 2015 were selected and divided into ischemic chest pain group (59 cases)and non-ischemic chest pain group (41 ca-ses).The Ischemic chest pain group was further divided into unstable angina group (39 cases)and acute myocardial in-farction group (20 cases).The venous blood was collected at the instant,3 h and 24 h after admission.Creatine kinase isoenzyme (CK-MB),cardiac troponin I (cTnI)and IMA were determined.Results]At the instant and 3 h after admis-sion,the IMA of the ischemic chest pain group was significantly higher than that of the non-ischemic chest pain group (P <0.05),while there was no significant difference between cTnI and CK-MB level (P >0.05).At 24 h after admis-sion,there was no significant difference in IMA between the ischemic chest pain group and the non-ischemic chest pain group (P >0.05);cTnI and CK-MB of the ischemic chest pain group were significantly higher than those of the non-is-chemic chest pain group (P <0.05).At the instant,3 h and 24 h after admission ,IMA level between the unstable angi-na group and the acute myocardial infarction group was not statistically significant (P >0.05).Conclusion]Ischemia Modified Albumin is a sensitive index for early diagnosing ischemic chest pain and non-ischemic chest pain,but could not diagnose unstable angina and acute myocardial infarction.