Turedi Suleyman, Gunduz Abdulkadir, Mentese Ahmet, Karahan Suleyman Caner, Yilmaz Sennur Ekici, Eroglu Oguz, Nuhoglu Irfan, Turan Ibrahim, Topbas Murat
Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey.
Am J Emerg Med. 2007 Sep;25(7):770-3. doi: 10.1016/j.ajem.2006.12.013.
Pulmonary embolism (PE) is a common condition, but the diagnostic strategy for the evaluation of suspected PE is somewhat controversial. Despite the use of various biochemical markers (such as D-dimer and C-reactive protein) and various probability calculation algorithms based on clinical findings for that purpose, there is still a need for more specific and practical markers in PE diagnosis. The aim of this study was to investigate the diagnostic value of ischemia-modified albumin (IMA) levels in the diagnosis of PE.
This case-control study was performed in the emergency department between March and September 2006. The serum IMA levels of a total of 60 individuals, consisting of 30 PE patients who had been definitively diagnosed via spiral computed tomographic angiography and 30 healthy volunteers, were examined.
The measurement of IMA levels in patient plasma yielded mean values of 0.724 +/- 0.122 absorbance unit (ABSU) in the PE group and 0.360 +/- 0.090 ABSU in the control group. When plasma IMA levels in the PE group were compared with those in the control group, statistically significant increases in IMA were observed in the former (t = 13.19, df = 56, P < .0005). The value of 0.540 ABSU was calculated as the upper limit of reference interval. In the PE group, 97.7% (n = 29) had values exceeding 0.540 ABSU; none of the control subjects had values exceeding this cutoff value.
In conclusion, our data suggest that IMA levels may be useful as a discriminative marker to exclude pulmonary embolism.
肺栓塞（PE）是一种常见病症，但对于疑似PE的评估，其诊断策略存在一定争议。尽管为此使用了各种生化标志物（如D - 二聚体和C反应蛋白）以及基于临床发现的各种概率计算算法，但在PE诊断中仍需要更具特异性和实用性的标志物。本研究的目的是探讨缺血修饰白蛋白（IMA）水平在PE诊断中的价值。
本病例对照研究于2006年3月至9月在急诊科进行。共检测了60人的血清IMA水平，其中包括30例经螺旋计算机断层血管造影确诊的PE患者和30名健康志愿者。
患者血浆中IMA水平的测量结果显示，PE组的平均值为0.724±0.122吸光度单位（ABSU），对照组为0.360±0.090 ABSU。将PE组的血浆IMA水平与对照组进行比较时，前者的IMA水平有统计学意义的升高（t = 13.19，自由度 = 56，P <.0005）。计算得出参考区间上限值为0.540 ABSU。在PE组中，97.7%（n = 29）的值超过0.540 ABSU；对照组中无一例的值超过此临界值。
总之，我们的数据表明IMA水平可能作为排除肺栓塞的鉴别标志物有用。
