CAJ | 학술논문

目的研究缺血修饰白蛋白(IMA)对微血管心绞痛的鉴别诊断价值.方法反复胸痛发作行诊断性冠状动脉造影检查示冠状动脉无病变者40例,行心电图平板运动试验(TET)检查,并根据试验结果分为微血管心绞痛组(TET阳性)及非心源性胸痛组(TET阴性),胸痛发作即刻抽血,统一行血清IMA、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)检查.结果微血管心绞痛组15例,非心源性胸痛组25例,微血管心绞痛组中12例血清IMA值高于正常范围(＞78.1 U/ml),3例在正常范围内(0～78.1 U/ml),平均IMA值(82±4) U/ml;非心源性胸痛组25例血清IMA值均在正常范围内,平均IMA值(66±6)U/ml.两组血清IMA值比较差异有统计学意义(t=8.7,P＜0.05).两组CK-MB、cTnI值比较差异无统计学意义,且测定值均在正常范围内.结论 IMA能反映早期心肌缺血,可作为协助鉴别微血管心绞痛与非心源性胸痛的一项生物学标志物.
목적 연구결혈수식백단백(IMA)대미혈관심교통적감별진단개치.방법 반복흉통발작행진단성관상동맥조영검사시관상동맥무병변자40례,행심전도평판운동시험(TET)검사,병근거시험결과분위미혈관심교통조(TET양성)급비심원성흉통조(TET음성),흉통발작즉각추혈,통일행혈청IMA、기산격매동공매(CK-MB)、기개단백I(cTnI)검사.결과 미혈관심교통조15례,비심원성흉통조25례,미혈관심교통조중12례혈청IMA치고우정상범위(＞78.1 U/ml),3례재정상범위내(0～78.1 U/ml),평균IMA치(82±4) U/ml;비심원성흉통조25례혈청IMA치균재정상범위내,평균IMA치(66±6)U/ml.량조혈청IMA치비교차이유통계학의의(t=8.7,P＜0.05).량조CK-MB、cTnI치비교차이무통계학의의,차측정치균재정상범위내.결론 IMA능반영조기심기결혈,가작위협조감별미혈관심교통여비심원성흉통적일항생물학표지물.
Objective To investigate the differential diagnosis value of ischemia-modified albumin(IMA) on microvascular angina.Methods Forty patients with normal coronary by diagnostic coronary angiography for recurrent angina underwent the treadmill test electrocardiogram(TET) and were divided into two groups:microvascular angina group (TET positive),non-cardiac pain group (TET negative),according to the result of TET.The serum IMA,creatine kinase-MB (CK-MB) and troponin Ⅰ (cTnI) levels were measured when the chest pain setted on.Results Of all the 40 patients,15 cases were diagnosed as microvascular angina,25 cases were diagnosed as non-cardiac pain.In microvascular angina group,mean IMA level was(82 ± 4)U/ml,12 cases were above the normal level (＞ 78.1 U/ml),3 cases were normal (0-78.1 U/ml) ; In the non-cardiac pain group,mean IMA level was (66 ±6) U/ml,25 cases were all in the normal level.Serum IMA level in the microvascular angina group was significantly elevated compared with the noncardiac pain group (t =8.7,P ＜0.05).CK-MB and cTnI level had no statistically difference between the two groups.Conclusions IMA can reflet the early myocardialischemia and may be useful as a discriminative marker to distinguish microvascular angina.