联合测定缺血修饰白蛋白等生化标志物对急性冠脉综合征早期诊断的价值（英文）

目的：探讨生化标志物联合检测对急性冠脉综合征（ACS）的早期诊断价值。方法：对156例因胸痛4 h就诊患者,以冠状动脉造影（CAG）为诊断依据,分为ACS组（112例）和非缺血性胸痛（NICP）组（44例）。在胸痛〈4 h和4~8 h分别抽血测定缺血修饰白蛋白（IMA）,乳酸脱氢酶（LDH）,肌酸激酶（CK）,肌酸激酶同工酶（CK-MB）及心脏肌钙蛋白I（cTnI）等心脏生化标志物,并结合CAG检查结果进行综合分析。结果：在发病4h内对ACS诊断敏感性最高的是IMA（87.50%）,特异性最高的是cTnI达95.45%,准确性最高的是IMA达80.77%;4~8h对ACS诊断敏感性最高的是IMA,达91.07%,特异性最高的是cTnI（97.73%）,准确性最高的是CK和IMA,二者分别为85.90%,85.25%,无显著差异,并列第一。综合判断,无论是〈4h,还是4~8h,敏感性和准确性最高的是IMA,特异性最高的是cTnI。4 h内IMA等5项指标联合检测可提高敏感性达89.28%,特异性达95.45%,准确性达91.02%,均为最高水平。结论：对于诊断急性冠脉综合征,IMA的敏感性和准确性最高,cTnI的特异性最高,IMA等5种指标联合检测可将其诊断提高到最高水平

Early diagnostic value of combined detection of ischemia-modified albumin and other biochemical markers for acute coronary syndrome

Objective：To explore early diagnostic value of combined detection of ischemia-modified albumin and other biochemical markers for acute coronary syndrome（ACS）.Methods：A total of 156 patients,who received treatment within 4h because of chest pain onset,were divided into ACS group（n=112）and non-ischemic chest pain group（NICP group,n=44）according to coronary angiography（CAG）.Blood sample was taken within4h and during 4~8h after chest pain to measure cardiac biochemical markers,including ischemia-modified albumin（IMA）,LDH,CK,CK-MB and cardiac troponin I（cTnI）,comprehensive analysis was performed by detected results of above biochemical markers and CAG.Results：For diagnosis of ACS,within 4h after onset IMA possessed highest sensitivity（87.50%）and highest accuracy（80.77%）,cTnI possessed highest specificity（95.45%）;In 4~8h IMA still possessed highest sensitivity（91.07%）,cTnI still possessed highest specificity（97.73%）,CK（85.90%）,and IMA（85.25%）possessed highest accuracy（both CK and IMA had no significant difference）;According to comprehensive analysis,regardless of within 4h or during 4~8h after chest pain,IMA possessed highest sensitivity and highest accuracy,cTnI possessed highest specificity.Within4h after chest pain,Detection of IMA combined abovementioned other four indexes increased sensitivity（89.28%）,specificity（95.45%）and accuracy（91.02%）to highest level.Conclusion：For diagnosis of ACS,IMA possesses highest sensitivity and highest accuracy,cTnI possesses highest specificity;IMA combined above-mentioned other four indexes may increase sensitivity,specificity and accuracy to highest level.