目的 探讨蛛网膜下腔出血（subarachnoid hemorrhage, SAH）患者不同分级时血清缺血修饰白蛋白（ischemia modified albumin, IMA）的水平变化及对预后判断的意义。方法 94例SAH患者根据Fisher CT分级分组（1级24例、2级27例、3级22例、4级21例），检测其血清中IMA的水平。结果 Fisher CT分级1级、2级、3级、4级时IMA水平分别为36.47±4.05、42.26±4.67、45.71±4.92、79.63±7.28。SAH患者病情轻型组的IMA和中国临床神经功能缺损评分（CSS积分）分别为37.71±4.14、6.38±3.13；中型组为 49.24±5.06、24.76±7.53；重型组为78.33±6.94、42.67±9.25。SAH出院时预后良好组IMA和改良Rankin评分（modified rankin scale，mRS）分别为38.64±4.17、2.85±3.13，预后不良组为60.85±6.01、28.67±8.65。结论 SAH的发病过程中IMA水平明显升高，其水平和SAH的分级和预后有一定关联性，可作为SAH的预后判断指标之一。

Objective To explore the changes of serum ischemia modified albumin (IMA) in subarachnoid hemorrhage (SAH) patients with different grades and its prognostic significance. Methods 94 SAH patients were classified into four groups (24 cases of level 1, 27 cases of level 2, 22cases of level 3, and 21cases of level 4) according to Fisher CT classification. The serum IMA levels were detected. Results The IMA levels in Fisher CT level 1, level 2, level 3, level 4 were 36.47±4.05, 42.26±4.67, 45.71±4.92, and 79.63±7.28 respectively. The IMA levels and Chinese clinical neural function defect scale integral (CSS) in SAH patients light group were 37.71±4.14, 6.38±3.13; in medium group were 49.24±5.06, 24.76±7.53; in severe group were 78.33±6.94, 42.67±9.25. The IMA levels and Rankin scale (modified Rankin scale, mRS) of SAH in discharge group with good and modified prognosis were 38.64±4.17, 2.85±3.13, in poor prognosis group were 60.85±6.01, 28.67±8.65. Conclusion The IMA levels are increased significantly in the process of SAH. The IMA level could be used as an indicator to predict the prognosis of SAH.