CAJ | 학술논문

目的：探讨缺血修饰白蛋白（IMA）诊断早期急性冠状动脉综合征（ACS）的价值。方法分别测定68例健康者（对照组）、78例 ACS 患者[其中不稳定型心绞痛（UA）患者55例，急性心肌梗死（AMI）患者23例]发病3 h、6 h 的血清IMA、肌钙蛋白 I（cTnI）、肌酸激酶同工酶（CK－MB）水平；分析 IMA、cTnI、CK－MB 诊断 ACS 的效能。结果UA、AMI 组发病3 h、6 h 时血清 IMA 水平与对照组比较，差异均有统计学意义（P ＜0．05）；两组发病3 h、6 h 血清 IMA 水平明显高于对照组（P ＜0．05）。 UA、AMI 组发病3 h 时血清 cTnI、CK－MB 水平与对照组比较，差异无统计学意义（P ＞0．05），但6 h 血清cTnI、CK－MB水平明显高于对照组（P ＜0．05）。3 h 时 IMA 诊断 ACS 的灵敏度、特异度分别为84．6％、80．9％，cTnI 分别为7．7％、92．6％，CK－MB 分别为10．3％、86．8％，IMA、cTnI、CK－MB 3项指标联合诊断的灵敏度、特异度分别为85．9％、97．1％。6 h时IMA 诊断 ACS 的灵敏度、特异度分别为76．9％、83．8％，cTnI 分别为38．5％、97．1％，CK－MB 分别为44．9％、92．6％，IMA、cTnI、CK－MB 3项指标联合诊断的灵敏度、特异度分别为94．9％、98．5％。结论血清 IMA 水平可作为 ACS 患者早期心肌缺血诊断的灵敏指标，IMA、cTnI、CK－MB 联合检测可提高诊断效能。
목적：탐토결혈수식백단백（IMA）진단조기급성관상동맥종합정（ACS）적개치。방법분별측정68례건강자（대조조）、78례 ACS 환자[기중불은정형심교통（UA）환자55례，급성심기경사（AMI）환자23례]발병3 h、6 h 적혈청IMA、기개단백 I（cTnI）、기산격매동공매（CK－MB）수평；분석 IMA、cTnI、CK－MB 진단 ACS 적효능。결과UA、AMI 조발병3 h、6 h 시혈청 IMA 수평여대조조비교，차이균유통계학의의（P ＜0．05）；량조발병3 h、6 h 혈청 IMA 수평명현고우대조조（P ＜0．05）。 UA、AMI 조발병3 h 시혈청 cTnI、CK－MB 수평여대조조비교，차이무통계학의의（P ＞0．05），단6 h 혈청cTnI、CK－MB수평명현고우대조조（P ＜0．05）。3 h 시 IMA 진단 ACS 적령민도、특이도분별위84．6％、80．9％，cTnI 분별위7．7％、92．6％，CK－MB 분별위10．3％、86．8％，IMA、cTnI、CK－MB 3항지표연합진단적령민도、특이도분별위85．9％、97．1％。6 h시IMA 진단 ACS 적령민도、특이도분별위76．9％、83．8％，cTnI 분별위38．5％、97．1％，CK－MB 분별위44．9％、92．6％，IMA、cTnI、CK－MB 3항지표연합진단적령민도、특이도분별위94．9％、98．5％。결론혈청 IMA 수평가작위 ACS 환자조기심기결혈진단적령민지표，IMA、cTnI、CK－MB 연합검측가제고진단효능。
Objective To investigate the value of ischemia modified albumin(IMA) in the early diagnosis of acute coronary syndrome (ACS).Methods The serum levels of IMA,cardiac troponin I(cTnI) and creatine kinase isoenzyme MB(CK-MB) were determined in 68 healthy controls(control group) and 78 patients with ACS including 55 with unstable angina(UA) and 23 with acute myocardial infarction(AMI) 3 and 6 hours after ACS attack.And their value in the early diagnosis of ACS was assessed.Results There was significant difference in the serum levels of IMA between UA or AMI group 3 and 6 hours after ACS attack and the control(P <0.05).The serum levels of IMA in both AMI and UA groups were significantly higher than those in the control group 3 and 6 hours after ACS attack(P <0.05).The serum levels of cTnI or CK-MB showed no significant difference between UA or AMI group 3 hours after ACS attack and the control(P >0.05), while the serum levels of cTnI and CK-MB of UA and AMI groups were significantly higher than those of control group 6 hours after ACS attack(P <0.05).The sensitivities of IMA,cTnI and CK-MB for diagnosis of ACS 3 hours after ACS attack were 84.6%,7.7% and 10.3%,respectively,while the specificities were 80.9%,92.6% and 86.8%,respectively;the sensitivity and specificity of combined detection(IMA,cTnI and CK-MB) were 85.9% and 97.1%,respectively.The sensitivities of IMA,cTnI and CK-MB for diagnosis of ACS 6 hours after ACS attack were 76.9%,38.5% and 44.9%,respectively,while the specificities were 83.8%,97.1% and 92.6%,respectively;the sensitivity and specificity of combined detection(IMA,cTnI and CK-MB) were 94.9% and 98.5%,respectively.Conclusion The serum level of IMA can act as an sensitive index of early diagnosis of myocardial ischemia.The combined detection of IMA,cTnI and CK-MB might increase the diagnostic accuracy for ACS patients.