缺血修饰白蛋白在急性胸痛患者中早期诊断价值研究

目的：探讨血清缺血修饰白蛋白（Ischemia modified albumin,IMA）在急性胸痛患者中的早期诊断价值。方法：随机选取以急性胸痛症状入院的患者113例。根据高敏肌钙蛋白（hs-TnT）检测结果,最终确诊为ACS（Acute coronary syndrome）胸痛组59例,非ACS胸痛组54例。另选择同期来我院体检的健康者60例作为对照组。分别于入院后即刻、4~8h、24h采血检测患者血清IMA及hs-TnT。组间比较采用t检验,并通过ROC曲线取得IMA诊断ACS最佳cut-off值。结果：ACS胸痛组与非ACS胸痛组、对照组相比,IMA水平明显增高,差异具有统计学意义（P〈0.05）;ACS胸痛组3次IMA测量值间均有显著统计学差异（P〈0.05）,且IMA在入院后4~8h达到最高;ROC曲线下面积为0.872,选择81.3Uoml-1为诊断临界点时,特异度为88.9%,灵敏度为74.6%。结论：血清IMA可能是急性胸痛患者早期诊断ACS的重要指标。

The value of ischemia modified albumin in the early diagnosis of acute chest pain

Objective：To study the value of serum ischemia modified albumin in the early diagnosis of patients with acute chest pain. Method： 113 patients with acute chest pain were randomly selected. According to hs TnT test results,59 cases were finally diagnosed with ACS chest pain group,the remaining 54 cases were diagnosed with non ACS chest pain group, 60 healthy physical cases were selected as control group. Serum IMA and hs-TnT were test ed immediately,4~8 hours, 24 hours after admission. T test was used to compare IMA between the different groups,and receiver operating characteristic curve was obtained. The ideal cut-off value of IMA was calculated by receiver operating characteristicl curve analysis. Result：The mean IMA levels were higher in ACS groups than non ACS groups and control group,and the difference were statistically significant （P〈0.05）. The 3 IMA readings in ACS groups had statistically significant differences. The highest reading appeared in 4~8 hours after admission. The area under the ROC curve was 0. 872,when the cut-off value of IMA was set as 81.3 Uoml-l,the specificity was 88.9 % and the sensitivity was 74.6 %. Conclusion： Serum IMA may be an important biomarker in the early di agnosis of ACS patients with acute chest pain.