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目的:探讨血清缺血修饰白蛋白(IMA)对急性冠状动脉综合征早期的诊断价值。方法:将56例急性冠状动脉综合征患者分为三组,不稳定性心绞痛组(n=25),ST抬高心肌梗死组(n=20),非ST抬高心肌梗死组(n=11),另选50例健康体检者为正常对照组。分别于胸痛发作2、4、6、12及24 h抽血检测56例急性冠状动脉综合征患者的血清缺血修饰白蛋白、肌钙蛋白Ⅰ(cTnI)、肌酸激酶MB同工酶(CK-MB),分析缺血修饰白蛋白对急性冠状动脉综合征的诊断价值。结果:在急性冠状动脉综合征患者中缺血修饰白蛋白水平于胸痛发作2小时已明显增高并达高峰,4小时仍持续增高,明显高于正常对照组(P<0．01),6小时降至正常。而CK-MB、cTnI水平在胸痛发作4小时开始增高,6小时明显增高,以后逐步递增并在24小时达高峰。不稳定型心绞痛、ST抬高的心肌梗死、非ST抬高的心肌梗死三组中,缺血修饰白蛋白水平升高以不稳定型心绞痛组最明显。结论:缺血修饰白蛋白是诊断急性冠状动脉综合征的早期敏感指标,是目前唯一的诊断心肌缺血的生化标志物。
Objective: To investigate the value of serum ischemic modified albumin (IMA) in early diagnosis of acute coronary syndrome. Methods: Fifty-six patients with acute coronary syndrome were divided into three groups: unstable angina pectoris group (n = 25), ST elevation myocardial infarction group (n = 20), non-ST elevation myocardial infarction group ), Another 50 healthy subjects were normal control group. Blood samples were collected from patients with acute coronary syndrome (ACS) at 2, 4, 6, 12 and 24 h after onset of chest pain respectively. Serum ischemia-modified albumin, cTnI and creatine kinase MB isoenzymes (CK -MB), analysis of ischemic modified albumin in the diagnosis of acute coronary syndrome. Results: The level of ischemia-modified albumin in patients with acute coronary syndrome increased significantly and reached the peak at 2 hours after onset of chest pain and continued to increase at 4 hours, which was significantly higher than that of the normal control group (P <0.01) Down to normal. The levels of CK-MB and cTnI increased at 4 hours after onset of chest pain, increased significantly at 6 hours, then gradually increased and peaked at 24 hours. Among the three groups of unstable angina pectoris, ST-elevation myocardial infarction, and non-ST-elevation myocardial infarction, the level of ischemic-modified albumin was the most pronounced in patients with unstable angina. Conclusion: Ischemia-modified albumin is an early sensitive marker for the diagnosis of acute coronary syndromes and is the only biochemical marker for diagnosis of myocardial ischemia.