RESUMO
Acute myocardial ischemia is the most common cause of sudden cardiac death.The diagnosis of early myocardial ischemia is a hot point in forensic medicine,which is also an early and important part for a prevention against myocardial infarction.This paper conducts a comprehensive discussion of the structure,function,clinical value and forensic medicine application prospect of ischemia modified albumin (IMA) and heart-type fatty acid binding protein (H-FABP),aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.
RESUMO
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 40.65U/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.
