目的 探讨血清缺血修饰白蛋白(IMA)对急性冠状动脉综合征(ACS)的诊断价值.方法 测定38例不稳定型心绞痛(UA),42例急性心肌梗死(AMI)及29例非冠心病(CHD)患者血清IMA、肌酸激酶同工酶(CK-MB)及肌钙蛋白T(cTnT)水平.结果 AMI组CK-MB、cTnT均显著高于非CHD组(P＜0.01);UA组及AMI组血清IMA均显著高于非CHD组(P＜0.01),两组患者发病6 h内均显著高于发病6 ～12 h(P＜0.01),发病6 ～12 h患者与非CHD组比较无明显差异(P>0.05).以IMA≥67.70 U/mL为阳性,得出IMA诊断ACS的灵敏度为88.8%,特异度为79.3%.结论 IMA可成为早期诊断心肌缺血的标志物,其诊断ACS的敏感性及阴性预测值均较高.%Objective To explore the value of ischemia modified ali>umin( IMA )in the diagnosis of a-cute coronary syndrome( ACS). Methods Serum IMA,CK-MB and cTnT levels in the 38 unstable angina pectoris( UA )group,42 acute myocardial infarction( AMI )group,were tested. The results were compared andstudied with 29 non-coronary heart disease( NCHD )group. Results In the group of AMI,the values of CK-MB and cTnT were obviously higher than the group of NCHD( P <0.01 ); in the group of UA and AMI,thevalues of IMA were obviously higher than the group of NCHD( P <0. 01 ),and the values of IMA within 6hours were obviously higher than the period from 6 to 12 hours( P <0.01 ). But no statistical significance was found by comparing the values of IMA from 6 to 12 hours with the NCHD group( P > 0. 05 ). If the valuehigher or equal to 67.70 U/mL is set as positive,the sensitivity of IMA in the diagnosis of ACS was 88.8% ,the specificity was 79. 3%. Conclusion IMA may be a marker for early diagnosis of myocardial ischemia, the sensitivity and negative predictive value of which for ACS are both high.
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