摘要
目的评价缺血修饰白蛋白(IMA)在急性冠状动脉综合征(ACS)早期诊断中的意义。方法132例疑似ACS患者在胸痛发作5小时内采血测定IMA、肌钙蛋白I(cTnI),入院即刻描记12导联心电图(ECG)。入选患者均经规范诊断、危险分层、标准治疗。IMA测定结果由吸光度单位表示,经受试者工作曲线(ROC曲线)分析获得区分非心肌缺血性胸痛(NICP)与ACS最适界值点(Cutoff)值。IMA、cTnI及ECG结果分别或联合与最终诊断结果(NICP,ACS)进行综合分析,评价其诊断ACS的临床价值。结果NICP与ACS组间IMA值差异有统计学意义,ROC曲线下面积0.978,在Cutoff值ABUS=0.525时敏感性和特异性分别为91.6%和89.8%。入院即刻检查IMA、cTnI和ECG诊断ACS的敏感性分别为85%,20%和40%,而三者联合可提高诊断敏感性至95%。结论IMA可对急性心肌缺血做出早期诊断,且明显提高对ACS早期诊断敏感性。
Objective To research the early diagnostic value of ischemia modified albumin（IMA） for acute coronary syndrome（ACS）. Methods One hundred and thirty-two patients with suspected ACS within five hours of acute chest pain were included. On admission, a 12-lead eleetrocardiogram（ECG） was recorded and blood samples were taken for IMA and cardiac troponin I （cTnI） measurement. Patients underwent standardized triage, diagnostic procedures and treatment. Results of IMA showed with absorbanee units（ABSU）. Receiver Operator Characteristive Curve（ROC curve） analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS from non ischemic individuals（NICP）. Results of IMA, ECG and cTnI were correlated with final diagnosis and their diagnostic sensitivity was evaluated for ACS. Results There was a obvious distinction of IMA levels between the two groups（NICP and ACS）. Sensitivity and specificity at a cutoff value of 0. 525 ABSU were 91.6% and 89.8%. Sensitivity of IMA for ischemic origin of chest pain was 85% compared with 20% of cTnI and 40% of ECG, and sensitivity of the three tests combined got to 95%. Conclusion IMA may make an early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity of ACS significantly.
出处
《临床荟萃》
CAS
北大核心
2006年第9期617-620,共4页
Clinical Focus
