脑血液循环障碍患者急性期血清缺血修饰白蛋白的变化研究

目的探讨检测缺血修饰白蛋白（IMA）对脑血液循环障碍患者早期诊断的价值。方法选择脑外伤患者29例,高血压性血管病患者37例,脑梗死患者41例,动脉硬化性脑血管病患者36例,非血管性因素患者21例。所有患者在起病3h内、6 h、48 h、72h检测血IMA水平。另选取30例健康体检者作为对照组。结果高血压性血管病组、脑梗死组、动脉硬化性脑血管病组血清IMA水平高于对照组（P〈0.01）;脑外伤组和非血管性因素组血清IMA水平高于对照组（P〈0.05）;高血压性血管病、脑梗死、动脉硬化性脑血管病组血清IMA水平高于脑外伤组和非血管性因素组（P〈0.05）;区分患病组和对照组的最适临界点为：120.32U/mL,此时敏感性为90.22%,特异性为70.21%;脑梗死组血清IMA值在72h内有上升趋势（P〈0.05）。结论 IMA是反映脑血液循环障碍患者早期情况较敏感的指标,可用于早期诊断。

Clmnges of lschemia Modified Albumin in Cerebral Circulation Disorder Patients

Objective To explore the value of serum ischemia modified albumin （IMA） in the early diagnosis of cerebral circulation disorder. Methods The patients with cerebral trauma （n = 29） , hypertensive vascular dis- ease （ n = 37）, cerebral infarction （ n = 41 ） , arteriosclerotic cerebral vascular disease （ n = 36） and cerebritis （n = 21 ） were involved in this study. The IMA levels of all patients were detected within 3 hours of onset and 6, 48, 72 hours. Results The serum levels of IMA in hypertensive vascular disease, cerebral infarction, arte- riosclerotic cerebral vascular disease were significantly higher than those of healthy control （ P 〈 0.01 ） , the IMA levels in cerebral trauma and cerebritis were also higher than that in healthy control （ P 〈 0.05 ） , while the levels of IMA in hypertensive vascular disease, cerebral infarction and arteriosclerotic cerebral vascular were significantly higher than those in cerebral trauma and cerebritis （ P 〈 0.05 ）. The optimal cutoff value of IMA was 120.32U/mL in diagnosis of cerebral circulation disorder. At this point, its sensitivity and specificity were 90.22% and 70.21%. The levels of serum IMA at 3-72h in cerebral infarction would be upward trend. Con- clusion IMA might be used as a biochemical index in early diagnosis of cerebral circulation disorder.