Baydin Ahmet, Amanvermez Ramazan, Tuncel Özgür Korhan, Ocak Metin, Meric Murat, Cokluk Cengiz
Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayis University, 55139 Samsun, Turkey.
Department of Medical Biochemistry, Faculty of Medicine, Ondokuz Mayis University, 55139 Samsun, Turkey.
Am J Emerg Med. 2015 Apr;33(4):488-92. doi: 10.1016/j.ajem.2014.10.007. Epub 2014 Oct 12.
The aims were to investigate the role of serum ischemia-modified albumin (IMA), tumor necrosis factor α (TNF-α), and myeloperoxidase (MPO) and to evaluate the relationship between IMA and cardiac markers (creatine kinase myocardial isoenzyme [CK-MB] and cardiac troponin I [cTnI]) related to cardiac abnormalities in adult patients after nontraumatic subarachnoid hemorrhage (SAH).
Twenty-nine patients with nontraumatic SAH admitted to the emergency department and 20 healthy adults as the control group were included in the study. Ischemia-modified albumin, TNF-α, MPO, CK-MB, cTnI, and leukocyte count (white blood cell [WBC]) in the circulation were measured on admission.
Ischemia-modified albumin, TNF-α, and MPO levels were higher by mean values of 11.6%, 9.5%, and 2.9%, respectively, in patients with SAH compared with control group. However, levels of these parameters were not statistically different between the groups (P > .05). However, WBC, CK-MB, and cTnI values were significantly higher in patients with SAH compared with healthy control (P < .001, P < .01, and P < .05, respectively). White blood cell and cTnI levels in the circulation were positively correlated with patients' clinical severity (r = 0.598, P = .001 and r = 0.461, P = .012, respectively). Ischemia-modified albumin has a poor diagnostic value in comparison with WBC, CK-MB, and cTnI tests to differentiate between patients after SAH and controls according to receiver operating characteristic curve.
The results suggest that IMA is not better than CK-MB and cTnI in predicting a cardiac injury in patients after nontraumatic SAH.
目的是研究血清缺血修饰白蛋白（IMA）、肿瘤坏死因子α（TNF-α）和髓过氧化物酶（MPO）的作用，并评估IMA与非创伤性蛛网膜下腔出血（SAH）成年患者心脏异常相关的心脏标志物（肌酸激酶同工酶[CK-MB]和心肌肌钙蛋白I[cTnI]）之间的关系。
本研究纳入了29例入住急诊科的非创伤性SAH患者和20名健康成年人作为对照组。入院时测定循环中的缺血修饰白蛋白、TNF-α、MPO、CK-MB、cTnI和白细胞计数（白细胞[WBC]）。
与对照组相比，SAH患者的缺血修饰白蛋白、TNF-α和MPO水平分别平均高出11.6%、9.5%和2.9%。然而，这些参数在两组之间无统计学差异（P>.05）。然而，SAH患者的WBC、CK-MB和cTnI值显著高于健康对照组（分别为P<.001、P<.01和P<.05）。循环中的白细胞和cTnI水平与患者的临床严重程度呈正相关（分别为r = 0.598，P = .001和r = 0.461，P = .012）。根据受试者工作特征曲线，与WBC、CK-MB和cTnI检测相比，缺血修饰白蛋白在区分SAH患者和对照组方面的诊断价值较差。
结果表明，在预测非创伤性SAH患者的心脏损伤方面，IMA并不优于CK-MB和cTnI。
