缺血修饰白蛋白在急性冠状动脉综合征早期诊断中的价值.docVIP

缺血修饰白蛋白在急性冠状动脉综合征早期诊断中的价值 　　【摘要】 目的 探讨血清缺血修饰白蛋白（IMA）在急性冠状动脉综合征（ACS）早期诊断中的价值， 为临床医生对急性冠状动脉综合征早期诊断提供依据。方法 对血清中的IMA、肌酸激酶同I酶（CK-MB）含量进行测定， 分析IMA检测对于急性冠状动脉综合征早期诊断的价值。并对IMA与CK-MB的效能进行分析。比较两者灵敏度、特异度、阳性预测值和阴性预测值， 以此对IMA指标进行综合评价。对IMA、CK-MB及两者联合诊断进行效能分析， 比较各方法准确度。结果 ACS组血清IMA含量为（79.88±5.37）U/ml， 明显高于对照组。当临界值为73 U/ml时， 血清IMA检测判断ACS的灵敏度、特异度、阳性预测值和阴性预测值分别为89.6%、86.0%、84.93%和94.68%。CK-MB组的灵敏度、特异度、阳性预测值和阴性预测值分别为55.5%、90.0%、85.24%和61.31%，明显低于IMA组。IMA在对ACS诊断中敏感度高于CK-MB， 但特异性低于CK-MB。结论 血清IMA水平可作为ACS早期诊断和危险分层的灵敏指标， 可作为早期提示心肌缺血的生化标志物。与CK-MB比较， IMA的灵敏度较高但特异性较低， 诊断时应结合其他诊断指标、临床症状及一些影响检验的其他因素进行判断。 　　【关键词】 缺血修饰白蛋白 ；急性冠状动脉综合征 　　Early diagnostic value of ischemia modified albumin in acute coronary syndrome LIU Wei-dong， LI Man-yuan， ZHAO Jin-song， et al. Jinzhou Emergency Medical Rescue Center， Jinzhou 121000， China. 　　【Abstract】 Objective To investigate the value of serum ischemia modified albumin （IMA） in the early diagnosis of acute coronary syndrome （ACS）， and to provide evidence for early diagnosis of ACS for clinical doctors. Methods Content of serum IMA， creatine kinase-MB （CK-MB） was detected， and the value of IMA in early diagnosis of ACS was analyzed. The effectiveness of IMA and CK-MB were analyzed. Sensitivity， specificity， positive predictive value and negative predictive value were compared， in order to make comprehensive evaluation of IMA index. The accuracy of IMA， CK-MB and both joint diagnosis efficiency analysis were compared. Results The serum IMA content was （79.88±5.37） U/ml in the ACS group， which was obviously higher than the control group. When the critical value was 73 U/ml， serum IMA test in determining the sensitivity of the ACS， specificity， positive predictive value and negative predictive value were 89.6%， 86.0%， 84.93% and 94.68% respectively. The sensitivity， specificity， positive predictive value and negative predictive value of CK-MB group were 55.5%， 90.0%， 85.24% and 61.31%， which were significantly lower than the IMA group. The sensitivity of IMA