缺血修饰白蛋白在微血管性心绞痛鉴别诊断中的价值

目的 探讨缺血修饰白蛋白（IMA）对微血管性心绞痛（CSX）的鉴别诊断价值.方法 经冠状动脉造影检查示冠状动脉正常的反复胸痛患者50例,根据心电图运动试验结果分为微血管性心绞痛组（27例）和非心源性胸痛组（23例）;同期医院体检的年龄匹配的健康对照30例.测定各组血清IMA、CK-MB和cTnⅠ.结果 27例微血管性心绞痛组中25例血清IMA值高于正常范围,2例在正常范围内,平均血清IMA值（83±3）U/ml;非心源性胸痛组23例IMA均在正常范围内,平均血清IMA值（67±4）U/ml;正常对照组30例IMA均在正常范围内,平均血清IMA值（65±3）U/ml.微血管性心绞痛组与其它2组血清IMA值比较差异有统计学意义（P＜0.05）;3组CK-MB、cTnⅠ水平比较差异无统计学意义,且测定值均在正常范围内.结论 IMA是早期心肌缺血较为敏感的生化指标,可以用于鉴别诊断微血管性心绞痛和非心源性胸痛.

Differential diagnosis value of ischemia-modified albumin on cardiac syndrome X

Objective To explore the differential diagnosis value of ischemia modified albumin（IMA） on cardiac syndrome X.Methods Fifty patients with normal coronary by diagnostic coronary angiography for recurrent angina underwent the treadmill test electrocardiogram and were divided into two groups：cardiac syndrome X group,non-cardiac pain group,according to the result of TET.And thirty normal control with age matched.The serum IMA,creatine kinaseMB（CK-MB） and troponin Ⅰ（cTnⅠ） levels were mneasured when the chest pain setted on.Results Of all the 50 patients,27 cases were diagnosed as microvascular angina,23 Cases were diagnosed as non-cardiac pain.In cardiac syndrome X group,mean IMA level was （83±3） U/ml,25 cases were above the normal level,2 cases were normal;In the non-cardiac pain group,mean IMA level was （67± 4）U/ml,23 cases were all in the normal level;In the normal control group,mean IMA level was （65±3）U/ml,30 cases were all in the normal level.Serum IMA level in the cardiac syndrome X group was significantly elevated compared with the non-cardiac pain group and normal control group （P＜0.05）.CK-MB and cTnⅠ level had no statistically difference among the three groups.Conclusion IMA can reflect the early myocardial ischemia and may be useful as a discriminative marker to distinguish cardiac syndrome X.