CAJ | 학술논문

目的：评价缺血修饰清蛋白（IMA）在冠心病（CHD）中的诊断价值，并探讨IMA水平与冠脉硬化病变范围的相关性。方法入选冠状动脉造影（CAG）检查确诊的CHD患者88例（CHD组），分为稳定性心绞痛（SA组）16例，急性冠脉综合征（ACS组）72例。再将ACS组分为不稳定性心绞痛（UA组）30例，非ST段抬高型心肌梗死（NSTEMI组）19例，ST 段抬高型心肌梗死（STEMT组）23例。根据CAG结果，分为1支血管病变组、2支血管病变组和3支血管病变组。选取同期来该院体检的健康者62例作为对照组。结果 CHD组较对照组 IMA明显升高（P＜0．05）。ACS组IMA 水平明显高于SA组（P＜0．05）。NSTEMI组、STEMI组IMA水平高于UA组（P＜0．05）。IMA水平和冠状动脉病变支数呈显著正相关（P＜0．05，r＝0．570）。当受试者工作特征曲线（ROC）的cut-off值确定为80．10 U/mL时，曲线下面积为0．869，IMA诊断冠心病的敏感度为65．9％，特异度为98．4％。Logistic回归分析显示，IMA是冠心病的独立预测因子。结论 IMA在CHD诊断中具有较高阴性预测价值， IM A水平和冠状动脉硬化病变范围显著正相关。
목적：평개결혈수식청단백（IMA）재관심병（CHD）중적진단개치，병탐토IMA수평여관맥경화병변범위적상관성。방법입선관상동맥조영（CAG）검사학진적CHD환자88례（CHD조），분위은정성심교통（SA조）16례，급성관맥종합정（ACS조）72례。재장ACS조분위불은정성심교통（UA조）30례，비ST단태고형심기경사（NSTEMI조）19례，ST 단태고형심기경사（STEMT조）23례。근거CAG결과，분위1지혈관병변조、2지혈관병변조화3지혈관병변조。선취동기래해원체검적건강자62례작위대조조。결과 CHD조교대조조 IMA명현승고（P＜0．05）。ACS조IMA 수평명현고우SA조（P＜0．05）。NSTEMI조、STEMI조IMA수평고우UA조（P＜0．05）。IMA수평화관상동맥병변지수정현저정상관（P＜0．05，r＝0．570）。당수시자공작특정곡선（ROC）적cut-off치학정위80．10 U/mL시，곡선하면적위0．869，IMA진단관심병적민감도위65．9％，특이도위98．4％。Logistic회귀분석현시，IMA시관심병적독립예측인자。결론 IMA재CHD진단중구유교고음성예측개치， IM A수평화관상동맥경화병변범위현저정상관。
Objective To evaluate the value of ischemia modified albumin (IMA) in the diagnosis of coronary heart disease (CHD) and the correlation between IMA levels and the pathological scope of coronary atherosclerosis .Methods A total of 88 coro-nary heart disease(CHD) patients diagnosed by coronary arteriongraphy (CAG) were selected ,including stable angina pectoris (16 cases)(SA group) and acute coronary syndrome (72 cases)(ACS group) .ACS group was further divided into 3 groups :unstable an-gina pectoris(30 cases)(UA group) ,non-ST-elevation myocardial infarction (19 cases) (NSTEMI group) ,ST-elevation myocardial infarction(23 cases) (STEMI group) .According to the results of CAG ,CHD patients were divided into 3 groups:1 vessel lesion group ,2 vessels lesion group and 3 vessels lesion group ,and 60 healthy physical cases were selected as control group .Results IMA in the CHD group was significantly higher than in control group (P<0 .05) .IMA in the ACS group was higher than SA group (P<0 .05) .IMA in the NSTEMI group and STEMI group were significantly higher than UA group (P<0 .05) .IMA levels and the degree of coronary atherosclerosis were significantly positively correlated (P<0 .05 ,r=0 .570) .When the cut-off value of IMA was 80 .10 U/mL ,the area under the curve was 0 .869 ,the specificity was 98 .4% and the sensitivity was 65 .9% .Logistic regression a-nalysis showed that IMA was an independent predictor of CHD .Conclusion IMA has a high negative predictive value in the diag-nosis of CHD ,there was a significantly positive correlation between IMA level and the pathological scope of coronary atherosclero-sis .