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目的:评价比色法测定血清缺血修饰白蛋白(IMA)的临床应用价值。方法:采用比色法对46例心肌肌钙蛋白阳性或心电图ST段异常的急诊胸痛患者和70名健康体检者的血清IMA进行了检测,结果作ROC曲线分析和临床诊断特性评价。并与超滤法白蛋白钴结合试验进行比较。结果:精密度试验批内CV为1.3%,批间CV为1.8%。ROC曲线下面积0.995,当cutoff值为75 u/ml时,IMA对急性心肌缺血的敏感度、特异性和准确度分别为97.8%、91.4%及94.0%,阳性预测值、阴性预测值分别为88.2%和98.5%。2种方法测定血清IMA结果差异无统计学意义(P>0.05)。结论:比色法测定血清IMA,实验重复性良好,较超滤法实验方法简便。较高的实验敏感度和阴性预测值显示了IMA作为急性冠状动脉综合征排除诊断或胸痛鉴别诊断指标的临床价值。
Objective: To evaluate the clinical value of colorimetric determination of serum ischemia modified albumin (IMA). Methods: The colorimetric method was used to detect serum IMA in 46 cases of cardiac troponin-positive or ST-segment abnormal ECG patients with chest pain and 70 healthy subjects. The results were analyzed by ROC curve and clinical diagnostic characteristics. And compared with ultrafiltration albumin cobalt binding test. Results: The CV of the precision test was 1.3% and the CV between batches was 1.8%. The area under the ROC curve was 0.995. When the cutoff value was 75 u / ml, the sensitivity, specificity and accuracy of IMA for acute myocardial ischemia were 97.8%, 91.4% and 94.0% respectively. The positive predictive value and negative predictive value were respectively 88.2% and 98.5%. There was no significant difference between the two methods in the determination of serum IMA (P> 0.05). Conclusion: Colorimetric method for the determination of serum IMA, good reproducibility of the experiment, the experimental method is more convenient than ultrafiltration. The higher experimental and negative predictive value of the clinical value of IMA as an indicator of the diagnosis of acute coronary syndrome or differential diagnosis of chest pain.