缺血修饰白蛋白在冠状动脉介入术中的变化及意义

目的观察冠心病患者经皮冠状动脉介入术所诱导的短暂心肌缺血中血清缺血修饰白蛋白、血浆心肌肌钙蛋白T及心肌型肌酸激酶同功酶的浓度变化及其临床意义。方法123例行经皮冠状动脉介入术的冠心病患者,分别测定术前、术后3h血清缺血修饰白蛋白、血浆心肌肌钙蛋白T及心肌型肌酸激酶同功酶的水平,并与100例行冠脉造影证实为冠心病未行PCI患者以及93例行冠脉造影但证实冠脉正常患者术前、术后3h的上述指标的检测结果进行对比分析。结果123例经皮冠状动脉介入组的血清缺血修饰白蛋白术后3h较术前升高（P〈0.05）,而193例冠脉造影组的缺血修饰白蛋白术前术后无明显变化（P〉0.05）。3组血浆心肌肌钙蛋白T及心肌型肌酸激酶同功酶术前术后3h均无明显变化（P〉0.05）。结论缺血修饰白蛋白在可使心肌发生缺血缺氧损伤的经皮冠状动脉介入术后迅速升高,并早于心肌肌钙蛋白T。缺血修饰白蛋白是一个早期诊断心肌缺血的生化指标。

Changes and significances of serum ischemia modified albumin in percutaneous coronary intervention

Objective To observe the changes and clinical significances of percutaneous coronary intervention （PCI） on transient myocardial ischemia by observing the levels of ischemia modified albumin（IMA）,cardiac triponin T（cTnT） and creatine kinase MB （CK-MB）. Methods 123 patients with coronary heart disease received PCI.100 patients with coronary heart disease only received coronary angiography（CAG）,93 patients with normal coronary artery received CAG.All the patients above, blood samples were collected for determining IMA,cTnT and CK-MB before and 3 hours after CAG. Results IMA levels were elevated 3 hours after PCI （P〈0.05）. IMA levels were not significantly different 3 hours after CAG in 193 patients （P〉0.05）. Levels of cTnT and CK-MB remained unchanged among three groups （P〉0.05）. Conclusion Levels of IMA were quickly in- creased after myocardial ischemia and before elevations of cTnT. IMA is a sensitive marker of myocardial ischemia.