摘要
目的探讨血清缺血修饰白蛋白(IMA)检测在急性缺血性脑卒中(IS)诊断中的临床价值。方法对神经内科送检的329份血清标本(包括125例急性IS患者、60例其他神经系统疾病患者、60例健康体检志愿者)进行盲样检测IMA水平,并对其中12例于发病3 h内送院的急性IS患者每隔3 h采血一次。全部检测完毕后,对所有盲检结果进行统计分析。结果急性IS患者血清IMA水平明显高于疾病对照组(χ2=113.91,P<0.001)和健康对照组(χ2=119.49,P<0.001);对小面积梗死灶组、中面积梗死灶组、大面积梗死灶组进行Kruskal-Wallis H检验,差异均有统计学意义(χ2=88.81,P<0.001),梗死灶大小与血清IMA水平呈正相关;而疾病对照组与健康对照组间,差异无统计学意义(χ2=2.83,P>0.05);急性IS患者发病3 h血清IMA水平已显著高于健康对照组(χ2=28.45,P<0.001),并于9 h达峰值;血清IMA对急性IS的敏感度、准确度、阴性预测值分别为0.97、0.91、0.96。结论急性IS患者血清IMA水平明显增高,血清IMA检测对急性IS诊断有较高的敏感度、阴性预测值及准确度,可作为临床诊断急性IS的辅助指标。
Objective To explore the clinical value of ischemia modified albumin（IMA） in the diagnosis of acute ischemic stroke（IS）. Methods The IMA levels were detected in 329 serum specimens from 125 cases of acute IS,60 cases of other neurological disorders,and 60 healthy people. In addition,12 acute IS patients,who were sent to the hospital within 3 h after onset,were involved to sample the blood every 4 h. Then all the results of blind samples detection were analyzed statistically.Results The serum IMA level of acute IS patients was significantly higher than that of patients with other neurological disorders（χ2= 113. 91,P 0. 001） and healthy control group（χ2= 119. 49,P 0. 001）. Kruskal-Wallis H test showed there were significant difference among small-size,middle-size and large-size infarction groups（χ2= 88. 81,P 0. 001）,and the IMA level was positively related with the infarction size. The IMA level had no significant difference between other neurological disorders group and healthy control group（χ2= 2. 83,P 0. 05）. Serum IMA level of acute IS patients at 3h after onset was significantly higher than that of healthy people（χ2= 28. 45,P 0. 001）,and reached the peak at 9h. The sensitivity,accuracy and negative predictive value of IMA in acute IS diagnosis were 0. 97,0. 91 and 0. 96. Conclusion IMA level increased obviously in acute IS patients,it has better sensitivity,negative predictive value and accuracy in the diagnosis of acute IS,and can be used as a clinically assistant marker of acute IS.
出处
《中国卫生检验杂志》
北大核心
2014年第15期2191-2193,共3页
Chinese Journal of Health Laboratory Technology
基金
湛江市非资助科技攻关计划项目(2013B01008)
