The Study Of The Worthy Of Ischemia Modified Albumin In The Diagnosis Of Acute Myocardial Ischemia

Objective: 1. By detecting the development of ischemic modified albumin (IMA) after early myocardial ischemia,the sensitivity of IMA in the diagnosis of acute myocardial ischemia was recognised.2.By observing the IMA value change of cases suffered acute abdominal pain, respiratory failure, arteriosclerosis obliterans,the influence from ache or anoxaemia in other organs was found.Methods: 1.In the group of coronary artery disease (CAD),46 cases, venous blood were drew before PCI,5 minutes,2 hours,6 hours after the last balloon inflation.IMA was detected in every point, and cTnT was detected in the points when before PCI and 2 hours, 6 hours after the last balloon inflation.2.In each group of health examination (control group), acute abdominal pain, respiratory failure and arteriosclerosis obliterans, 30 cases, venous blood were drew when they had serious symptom and IMA were detected.Results: 1.In the group of PCI,the values of IMA in the points of before PCI ,5 minutes,2 hours,6 hours after the last balloon inflation were 67.235± 6.060 U/ml,76.966±5.402 U/ml, 77.349±5.571 U/ml, 69.344±5.217 U/ml respectively.There was statistical significance (p<0.001) when comparing the values in the points of 5 minutes and 2 hours after inflation with the values before and 6 hours after inflation,and the former is higher than the latter.No statistical significance(p=0.742>0.05) was found when comparing the values of the point of 2 hours and 5 minutes after inflation, there was also no statistical significance(p=0.069>0.05) between 6 hours after operation and before PCI.2. According to the values of before PCI and 2 hours after inflation,we constructed the ROC curve to discriminate myocardial ischemia event from non-myocardial ischemia event. The most suitable cutoff value was 72.6U/ml. The result was considered positive when the value was higher than 72.6U/ml, otherwise the result was negative.3. 39 cases of 46(84.78%) were found positive IMA results 2 hours after inflation,meanwhile the values of cTnT were all negative.3 cases, values (6.52%) of cTnT were positive when 6 hours after inflation, and of these cases we obtained 2 positive results in the value of IMA. So the positive rate of IMA was significantly higher than cTnT(p<0.001).4. No statistically significance(P=0.900>0.05) of the IMA value was found between cases suffered acute abdominal pain (71.087±5.861U/ml) and control group (70.933±3.087U/ml).The IMA value of acute gastroenceritis cases(74.261±5.205U/ml) was higher than control group (70.933±3.087U/ml),with a statistically difference (p=0.008<0.05). There was no statistically difference (P=0.612>0.05) between the other cases suffered acute abdominal pain (69.325±3.731U/ml) and the control group (70.933±3.087U/ml).5.The IMA value of respiratory failure cases(75.503±7.831U/ml) was higher than control group (70.933±3.087U/ml),with a statistically difference(p=0.004<0.05).6. The IMA value of arteriosclerosis obliterans cases(56.697±4.763 U/ml) was lower than control group (70.933±3.087U/ml), with a statistically difference(p<0.001).Conclusions: IMA is sensitive but not special enough in the diagnosis of acute myocardial ischemia.