[1]张梦轩,张冬娜,李 雪,等.血清IMA,H-FABP与hs-CRP水平联合检测在ACS早期诊断中的应用研究[J].现代检验医学杂志,2019,34(05):16-18.[doi:10.3969/j.issn.1671-7414.2019.05.005]
　ZHANG Meng-xuan,ZHANG Dong-na,LI Xue,et al.Application of Combined Detection of Serum IMA,H-FABP and hs-CRP Levels in Early Diagnosis of ACS[J].Journal of Modern Laboratory Medicine,2019,34(05):16-18.[doi:10.3969/j.issn.1671-7414.2019.05.005]
点击复制

血清IMA,H-FABP与hs-CRP水平联合检测在ACS早期诊断中的应用研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年05期
页码:
16-18
栏目:
论著
出版日期:
2019-10-29

文章信息/Info

Title:
Application of Combined Detection of Serum IMA,H-FABP and hs-CRP Levels in Early Diagnosis of ACS
文章编号:
1671-7414(2019)05-016-04
作者:
张梦轩1; 张冬娜2; 李 雪2; 魏 昆2; 朱光泽2
(1.长春中医药大学,长春 130117; 2.长春中医药大学附属医院检验科,长春 130021)
Author(s):
ZHANG Meng-xuan1; ZHANG Dong-na2; LI Xue2; WEIKun2; ZHU Guang-ze2
(1.Changchun University of Traditional Chinese Medicine,Changchun 130117,China; 2.Department of Clinical Laboratory,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Changchun 130021,China)
关键词:
缺血修饰蛋白;  心型脂肪酸结合蛋白;  超敏C反应蛋白;  急性冠脉综合征
分类号:
R541.4; R446.112
DOI:
10.3969/j.issn.1671-7414.2019.05.005
文献标志码:
A
摘要:
目的 探究联合检测血清中缺血修饰蛋白(ischemic modified protein,IMA)、心型脂肪酸结合蛋白(cardiac fatty acid binding protein,H-FABP)与超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平对急性冠脉综合征(acute coronary syndrome,ACS)早期诊断的应用价值。方法 选取2017年9月～2018年12月就诊于吉林省人民医院ACS患者共63例, 其中23例不稳定型心绞痛(unstable angina pectoris,UAP)患者作为UAP组、21例非ST段抬高型心肌梗死(non-ST-elevation myocardial infarction,NSTEMI)患者作为NSTEMI组、19例ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者作为STEMI组。选取30例健康人群作为对照组。分别比较四组受试者IMA,H-FABP与hs-CRP三项指标的检测水平,同时计算并比较IMA,H-FABP与hs-CRP单独及联合检测的灵敏度及受试者工作曲线(receiver operating characteristic,ROC)的曲线下面积(area under curve,AUC)。结果 UAP组的IMA,H-FABP与hs-CRP检测水平分别为69.19±13.67 U/ml,18.66±15.47 ng/ml和1.94±1.81 mg/dl; NSTEMI组的IMA,H-FABP与hs-CRP检测水平分别为72.18±13.04 U/ml,25.68±19.62 ng/ml和3.93±3.32 mg/dl; STEMI组的IMA,H-FABP与hs-CRP检测水平分别为78.85±14.78 U/ml,78.44±52.69 ng/ml和12.62±11.03 mg/dl,结果显示实验组的检测水平明显高于对照组,差异均有统计学意义(F=23.488～80.921,均P<0.05)。三组中IMA,H-FABP和hs-CRP联合检测的灵敏度分别为83%,86%和89%,均优于各组中三项指标单独检测的灵敏度。三项指标联合检测的AUC值为0.915,较单独检测准确度更高。结论 采用IMA,H-FABP与hs-CRP联合检测的方法可显著提高ACS早期诊断的准确度,为临床早期ACS诊断提供更为可靠有效的检测依据。
Abstract:
Objective To investigate the value of combineddetection of serum ischemia-modifying protein(IMA),cardiac fatty acid binding protein(H-FABP)and high-sensitivity C-reactive protein(hs-CRP)levelsin the early diagnosis of acute coronary syndrome(ACS).Methods A total of 63 patients with ACS who were admitted to the People's Hospital of Jilin Province from September,2017 to December,2018 were enrolled.Among them,23 patients with unstable angina pectoris(UAP)were UAP group,21 patients with non-ST-elevation myocardial infarction(NSTEMI)were NSTEMI group,19patients with ST-elevation myocardial infarction(STEMI)were STEMI group.30healthy people were selected as the control group.The detection levels of IMA,H-FABP and hs-CRP were compared among the four groups.Calculate and compare the sensitivity of IMA,H-FABP and hs-CRP alone and in combination,and the area under curve(AUC)of the receiver operating characteristic curve(ROC curve).Results The levels of IMA,H-FABP and hs-CRP in the UAPgroup were 69.19±13.67 U/ml,18.66±15.47 ng/ml and 1.94±1.81 mg/dl,respectively.The levels of IMA,H-FABP and hs-CRP in the NSTEMI group were 72.18±13.04 U/ml,25.68±19.62 ng/ml and 3.93±3.32 mg/dl,respectively.Thelevels of IMA,H-FABP and hs-CRP in the STEMI group were 78.85±14.78 U/ml,78.44±52.69 ng/ml and 12.62±11.03 mg/dl,respectively.And the results were significantly higher than those in the control group(F=23.488～80.921,all P<0.05).The sensitivity of combined detection of IMA,H-FABP and hs-CRP in the experimental group was 83%,86% and 89%,respectively,and the sensitivity of each group was better than that of three indicators alone.The AUC of the combined detection of the three indicators was 0.915,and the diagnostic accuracy was higher.Conclusion The combination of IMA,H-FABP and hs-CRP can significantly improve the accuracy of early diagnosis of ACS,and provide a more reliable and effective basisfor early diagnosis of ACS.

参考文献/References:

[1] MORROW D A,CANNON C P,JESSE R L,et al.National academy of clinical biochemistry laboratory medicine practice guidelines:clinical characteristics and utilization of biochemical markers in acute coronary syndromes[J].Circulation,2007,115(13):e356-e375.[2] THYGESEN K,ALPERT J S,WHITE H D.Universal definition of myocardial infarction[J].J Am Coll Cardiol,2007,50(22):2173-2195. [3] BURT C W.Summary statistics for acute cardiac ischemia and chest pain visits to United States EDs,1995-1996[J].Am J Emerg Med,1999,17(6):552-559. [4] GLATZ J F,VAN DER VUSSE G J,SIMOONS M L,et al.Fatty acid binding protein and the early detection of acute myocardial infarction[J].Clin Chim Acta,1998,272(1):87-92. [5] CHO C M,LEE Y M.The relationship between cardiovascular disease risk factors and gender[J].Health,2012,4(6):309-315. [6] 陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,33(1):1-8. CHEN Weiwei,GAO Runlin,LIU Lisheng,et al.Summary of China Cardiovascular Disease Report 2017[J].Chinese Circulation Journal,2018,33(1):1-8. [7] 王陇德,刘建民,杨弋,等.我国脑卒中防治仍面临巨大挑战—《中国脑卒中防治报告2018》概要[J].中国循环杂志,2019,34(2):105-119. WANG Longde,LIU Jianmin,YANG Yi,et al.The prevention and treatment of stroke still face huge challenges-Brief report on stroke prevention and treatment in China,2018[J].Chinese Circulation Journal,2019,34(2):105-119. [8] HJORTSHOJ S,DETHLEFSEN C,KRISTENSEN S R,et al.Kinetics of ischaemia modified albumin during ongoing severe myocardial ischaemia[J].Clin Chim Acta,2009,403(1/2):114-120. [9] GURUMURTHY P,BORRA S K,YERUVA R K,et al.Estimation of ischemia modified albumin(IMA)levels in patients with acute coronary syndrome[J].Indian JClin Biochem,2014,29(3):367-371. [10] MEHTA M D, MARWAH S A, GHOSH S,et al.A synergistic role of ischemia modified albumin and high-sensitivity troponin T in the early diagnosis of acute coronary syndrome[J].J Family Med Prim Care,2015,4(4):570-575. [11] BHAKTHAVATSALA REDDY C, CYRIAC C, DESLE H B.Role of “Ischemia Modified Albumin”(IMA)in acute coronary syndromes[J].Indian Heart J,2014,66(6):656-662. [12] GEREDE D M,G(¨overU)LEC S,KILICKAP M,et al.Co-mparison of a qualitative measurement of heart-type fatty acid-binding protein with other cardiacmarkers as an early diagnostic marker in the diagnosis of non-ST-segment elevation myocardial infarction[J].Cardiovasc J Afr,2015,26(6):204-209. [13] HONG Y J, JEONG M H, CHOI Y H,et al.AS-275:Relation between high-sensitivity C-reactive protein and coronary plaque components in patients with acute coronary syndrome:virtual histology-intravascular ultrasound analysis[J].Korean Circ J,2011,41(8):440-446. [14] LUKIN A,NOVAK K,POLIC S,et al.Prognostic value of low and moderatelyelevated C-reactive protein in acute coronary syndrome:a 2-year follow-up study[J].Med Sci Monit,2013,19:777-786. [15] RIBEIRO D R,RAMOS A M,VIEIRA P L,et al.High-sensitivity C-reactiveprotein as a predictor of cardiovascular events after ST-elevation myocardialinfarction[J].Arq Bras Cardiol,2014,103(1):69-75. [16] 周萍,肖尧,袁瑞丽,等.血清Hcy和hs-CRP水平检测在AMI早期临床诊断中的临床应用[J].现代检验医学杂志,2016,31(6):79-81. ZHOU Ping,XIAO Yao,YUAN Ruili,et al.Application value of serum Hcyand hs-CRP levels in early diagnosis of AMI[J].Journal of Modern Laboratory Medicine,2016,31(6):79-81.

相似文献/References:

[1]秦绪珍a,王丹晨a,叶益聪b,等.血清多种生化指标在PCI患者围术期的浓度变化[J].现代检验医学杂志,2018,33(01):35.[doi:10.3969/j.issn.1671-7414.2018.01.001]
　QIN Xu-zhena,WANG Dan-chena,YE Yi-congsup>b,et al.Perioperative Changes of Serum Biochemical Markers in Patients with PCI[J].Journal of Modern Laboratory Medicine,2018,33(05):35.[doi:10.3969/j.issn.1671-7414.2018.01.001]

备注/Memo

备注/Memo:
基金项目:吉林省科技发展计划项目(项目编号:20170204034YY); 吴阶平医学基金会临床科研专项资助基金(项目编号:320.6750.16068)。 作者简介:张梦轩(1992-),女,硕士研究生导师,检验医师,研究方向:临床检验诊断学,E-mail:510179174@qq.com。 通信作者:朱光泽,男,博士,主任技师,E-mail:zhuguangze820@126.com。
更新日期/Last Update: 2019-10-20