Creatine Kinase The Mbmass Quantification Of Acute Myocardial Infarction

Background and Objective:AMI is usually diagnosed by the measurement of CK, CK-MB activity in the most laboratories. But the sensitivity, specialty, positive predictive value, negative predictive value and diagnosis efficiency are not up to 100%. The reason is that CK-MB activity is measured by immunodepression method through.the biochemical dynamic analysis. The value of CK-MB activity is double of the CK-B activity under the hypothesis that the CK-BB activity is not exiting. As you know, the immunodepression is a sensitive methodology in measuring the CK-MB activities, but CK-MB activity does not specially distribute in the heart tissue, it could be found in other tissues and in some conditions such as hemolysis or huge CK. The false results may influence the value of CK-MB activity in diagnosing early AMI.Being a myocardial maker, creatine kinase isoenzyme MB mass (CK-MB mass) is the most important biochemical marker which can diagnose AMI in recent years. CK-MB mass is measured by micro-iron enzyme immunoassay method. Compared with the conventional enzyme detection method, the micro-iron enzyme immunoassay method has theinherent high sensitivity and specialty. It can get rid of the interference during the measurement process, exclude the influence of other protein and it has the response specially. We conclude that micro-iron enzyme immunoassay method can be used to measure the mass of serum enzyme protein. Some foreign authors had used CK-MB mass but not CK-MB activity to diagnose AMI and they suggested that CK-MB mass be more accurate and reliable than CK-MB activity.Reviewing the domestic and foreign literatures, we haven't found one artical in which the author observed the dynamic curve change of CK-MB mass in patients with non revasculization and judge the value of the CK-MB mass in diagnosis and prognosis of AMI.In this article, we measured CK-MB mass through micro-iron enzyme immunoassay method and compared it with CK-MB, CK activity simultaneously, we observed the time when myocardial enzymes which include CK-MB mass changed, the time of enzymes occurred abnormal, the time of the enzymes raised to peak, the duration of enzymatic peak were lasting and the time of enzymes dropping to normal from peak in patients who had non revasculization during therapy of the AMI. From all these data, we had obtained a mass or active -time curve. We can define the characteristic of the CK-MB mass's dynamic changes in AMI and the relationship between the CK-MB mass and the near prognosis of AMI which includes heart faliur and cardiac arrhythmia, etc. Methods:The blood samples of the seventy-one patients were drawn at the following time, on admission immediately, four to six hours after admission, then at intervals of six to eight hours until the enzymesdropped to normal in patients who had a routine theraphy and on admission immediately, two to four hours within twenty -four hours, four to six hours twenty-four hours later, then at intervals of twelve hours until the enzymes dropped to normal in patients who had the thrombolysis theraphy. Each sample was about two milliliter. The blood samples were centrifuged for ten minutes with 3000r/min and then the serum were measured or put into the refrigerator of -20 °C to waitting for measurement.CK-MB mass was measured by micro-iron enzyme immunoassay method, CK-MB activity was measured by Immunodepression method and CK were measured by velocity method. We calculated the time of these enzyme's dynamic changes.The depression and elevation of ST segments in ECG were measured and calculated.The cardiac arrhythmia was judged by Lown's grade. The heart function was judged by Killip's classes. It was also judged by the GPT activity and the BNP concentration. Results:1. micro-iron enzyme immunoassay method is convenient, accurate and reliable in determining of CK-MB mass.2.The peak of CK-MB mass was found at average 22.2 hours after AMI occurred in patients who had routing or thrombolysis therapy and the coronary arteries weren't reperfused. The duration of the enzyme peak was average 13.3 hours and it took average 71.2 hours dropping to normal. The time of CK-MB mass increasing to abnormal was found 2.2 hours, 4.2 hours earlier than CK-MB and CK activity and the time when the peakoccurred was 3.2 hours, 10.2 hours earlier, the duration of the peak was 7.8, 11.2 hours shorter, the duration of the peak dropping to normal was 7.7, 37.1 hours shorter respectively than CK-MB and CK activity. The difference was significantly.3.The change of CK-MB mass was found at average 3.2 hours after AMI occurred in patients without reperfusion by routine or thrombolysis therapy. However, CK-MB activity and CK activity were found at 5.4, 7.4 hours, thus, CK-MB mass could be used to diagnose AMI in the earlier time .4.The rate that the patients who had cardiac arrhythmias among patients without reperfusion was70.4% in Lown's grade one or two and 21.1% in Lown's grade three or higher. The mortality was 1.4 %. The cardiac function in Killip's degree higher than 2 was 46.0%.The CK-MBmass could be used to judge the prognosis of AMI. Conculsion:l.The measurement method of CK-MB mass is definited> convenientand practical.2.CK-MB mass is more special, more accurate and reliable than CK> CK-MB activities.3.Observing the enzymatic dynamic change which included the enzyme change's time> raising to peak's time> the duration of the peak of CK-MB mass ^ dropping to normal's time from the peak comparing with the CK> CK-MB activities simultaneously, we suggest that CK-MB mass be useful in the diagnosis of AMI.4.CK-MB mass is a special and sensitive myocardial marker, it could be used to diagnose early AMI, judge the near prognosis of AMI.