Immanuel Suzanna, Sanjaya Arief Indra
Department of Clinical Pathology, Faculty of Medicine, University of Indonesia-Dr. Cipto Mangunkusumo Hospital, Jakarta.
Acta Med Indones. 2006 Apr-Jun;38(2):92-6.
The biochemical marker of myocardial ischemia is detected prior to the development of myocardial necrosis, i.e. a novel biochemical evaluation based on human serum albumin binding to cobalt, a transitional metal. The evaluation is known as Albumin Cobalt Binding (ACB) Test. ACB Test is applied to detect the presence of Ischemia Modified Albumin (IMA), an albumin which has altered binding capacity to bind metal ion such as cobalt (Co), copper (Cu) and nickel (Ni) in N-terminus region. It is produced when the serum albumin convenes with ischemic heart tissues. ACB Test detecting the presence of myocardial ischemia that occurs prior to myocardial necrosis has been studied by some researchers and they found an ACB increase prior to troponin increase. The cut off point of ACB evaluation was 85 U/ml. Provided that the value was greater than 85 U/ml then there was positive myocardial ischemia. But it should be noticed that IMA increase in the plasma may be due to other tissues such as gastrointestinal tissues or skeletal muscles tissues. We should also consider other factors which may affect the evaluation result such as severe hypoalbuminemia that will cause a false-high result. ACB Test may be used as an early marker of myocardial ischemia that occurs prior to myocardial necrosis.
在心肌坏死发生之前检测心肌缺血的生化标志物，即基于人血清白蛋白与过渡金属钴结合的一种新型生化评估方法。该评估方法称为白蛋白钴结合（ACB）试验。ACB试验用于检测缺血修饰白蛋白（IMA）的存在，IMA是一种在N端区域与金属离子如钴（Co）、铜（Cu）和镍（Ni）结合能力发生改变的白蛋白。它是在血清白蛋白与缺血性心脏组织结合时产生的。一些研究人员对检测心肌坏死之前发生的心肌缺血的ACB试验进行了研究，他们发现ACB在肌钙蛋白升高之前就升高了。ACB评估的截断点为85 U/ml。如果该值大于85 U/ml，则存在阳性心肌缺血。但应注意，血浆中IMA升高可能是由于其他组织，如胃肠道组织或骨骼肌组织。我们还应考虑其他可能影响评估结果的因素，如严重低白蛋白血症会导致假高结果。ACB试验可作为心肌坏死之前发生的心肌缺血的早期标志物。
