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目的:探讨血浆缺血修饰白蛋白对急性肺栓塞(APE)的诊断价值。方法:检测39例确诊为APE患者及对照组30例健康受试者血浆缺血修饰白蛋白(IMA)、D-二聚体含量,利用ROC曲线分析并比较IMA、D-二聚体对APE的诊断价值。结果:APE组患者血浆IMA(75.84±15.70U/ml)、D-二聚体(5.41±5.29mg/L)较对照组明显增高(P<0.01),根据ROC曲线,IMA最佳界值为63.30U/ml,此时诊断APE的敏感性为87.2%,特异性为80%。D-二聚体最佳界值为0.57mg/L,此时诊断APE的敏感性为94.9%,特异性为66.7%。联合IMA、D-二聚体可提高诊断APE的特异性至90%(P<0.05)。IMA在APE高危、中危、低危各亚组之间差异有统计学意(P<0.05或0.01)。结论:IMA可用为APE的诊断标志物,检测IMA水平有助于APE的危险分层。
Objective: To investigate the diagnostic value of plasma ischemia-modified albumin in acute pulmonary embolism (APE). Methods: The plasma levels of IMA and D-dimer were measured in 39 healthy subjects who were diagnosed as APE and control group. The ROC curve was used to analyze the plasma levels of IMA and D-dimer in APE The diagnostic value. Results: The plasma IMA (75.84 ± 15.70U / ml) and D-dimer (5.41 ± 5.29mg / L) in APE group were significantly higher than those in control group (P <0.01). According to ROC curve, 63.30U / ml. At this time, the sensitivity of APE was 87.2% and the specificity was 80%. D-dimer best cutoff value of 0.57mg / L, the diagnosis of APE sensitivity was 94.9%, specificity of 66.7%. The combination of IMA and D-dimer increased the specificity of diagnosis of APE to 90% (P <0.05). There was a significant difference of IMA between the subgroups of high risk, moderate risk and low risk of APE (P <0.05 or 0.01). Conclusion: IMA can be used as a diagnostic marker of APE, detecting the level of IMA contributes to the risk stratification of APE.