法医学杂志

法医学杂志 ›› 2017, Vol. 33 ›› Issue (5): 493-496.DOI: 10.3969/j.issn.1004-5619.2017.05.009

• 论著 • 上一篇    下一篇

缺血修饰白蛋白在急性缺血性心脏病中的法医学应用

王  鹏1，2，朱泽磊2，3，朱  宁1，于  浩2，岳  强1，王晓龙2，冯春梅2，王昌亮2，张国华2   

  1. 1. 铁岭市公安局刑警支队，辽宁 铁岭 112000； 2. 中国医科大学法医学院，辽宁 沈阳 110001； 3. 北京市公安局石景山分局刑侦支队，北京 100043
  • 发布日期:2017-10-25 出版日期:2017-10-28
  • 通讯作者: 张国华，男，教授，博士研究生导师，主要从事法医学教学、科研和鉴定工作；E-mail：ghzhang@cmu.edu.cn
  • 作者简介:王鹏（1964—），男，主任法医师，主要从事法医学鉴定和科研工作；E-mail：wangpeng57369@163.com
  • 基金资助:

    公安部应用创新计划资助项目（2009YYCXLNST021）

Application of Ischemia Modified Albumin for Acute Ischemic Heart Disease in Forensic Science

WANG PENG1,2, ZHU ZE-LEI2,3, ZHU NING1, YU HAO2, YUE QIANG1, WANG XIAO-LONG2, FENG CHUN-MEI2, WANG CHANG-LIANG2, ZHANG GUO-HUA2   

  1. 1． Criminal Police Detachment, Tieling Public Security Bureau, Tieling 112000, China; 2. School of Forensic Medicine, China Medical University, Shenyang 110001, China; 3. Criminal Investigation Detachment, Shijingshan Branch of Beijing Public Security Bureau, Beijing 100043, China
  • Online:2017-10-25 Published:2017-10-28

被引次数

2

摘要： 目的 探讨心包液中缺血修饰白蛋白（ischemia modified albumin，IMA）水平在心脏性猝死诊断中的应用价值及法医学意义。 方法 应用白蛋白-钴离子结合法检测急性缺血性心脏病组（36例）、急性心肌梗死组（6例）、心肌病组（4例）、对照组（15例）死者的心包液中IMA水平，比较各组之间IMA水平的差异。通过ROC曲线获得最佳IMA水平的截断值以及区分急性缺血性心脏病和对照组的敏感度和特异度。 结果 急性缺血性心脏病组心包液中IMA水平高于对照组（P<0.05）；而与急性心肌梗死组、心肌病组心包液中IMA水平比较，差异均无统计学意义（P>0.05）。应用ROC曲线分析得出识别急性心肌缺血的IMA的截断值为40.65 U/mL，其诊断急性心肌缺血的敏感度为60.0%，特异度为80.5%。 结论 心包液中IMA有望作为诊断急性心肌缺血的参考指标，为心脏性猝死的法医学诊断提供客观依据。

关键词: 法医病理学, 猝死, 心脏, 心肌缺血, 白蛋白类

Abstract: Objective To explore the application value and forensic significance of ischemia modified albumin （IMA） in pericardial fluid to diagnose sudden cardiac death. Methods IMA level in pericardial fluid was detected in acute ischemic heart disease group （n=36）, acute myocardial infarction group （n=6）, cardiomyopathy group （n=4） and control group （n=15） by albumin cobalt binding method. The levels of IMA were compared among these groups. The best cut-off IMA value was estimated and the sensitivity and specificity of acute myocardial ischemia group was distinguished from control group by receiver operating characteristics （ROC） curve. Results The IMA level in acute ischemic heart disease group was significantly higher than that of control group （P<0.05）. Compared with acute myocardial infarction group and cardiomyopathy group, the IMA level in acute ischemic heart disease group had no significant difference （P<0.05）. The cut-off value for the identification of acute myocardial ischemia which obtained by ROC analysis was 40.65 U/mL. And the sensitivity and specificity for distinguishing acute ischemia cardiac disease was 60.0% and 80.5%, respectively. Conclusion The IMA value in pericardial fluid can be a reference marker for the diagnosis of acute myocardial ischemia, which also can provide objective basis for the forensic identification of sudden cardiac death.

Key words: forensic pathology, death, sudden, cardiac, myocardial ischemia, albumins

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