| PrefaceUnstable angina pectoris ( UA) is a clinical syndrome lies between stable angina pectoris ( SA) and acute myocardial infarction (AMI) . UA is a high risk syndrome that is ready to develop AMI or sudden death, so the clinicians concern about its prognosis estimation and early intervention. cTnI is a highly specific cardiac muscle structural protein. To determine the cTnI content using Anti-cTnI monoclonal antibody is more sensitive and specific than other cardiac enzymes. In this study, we measured the cTnI and CK-MB level of UA patient and the relationship to the prognosis. We also discuss the relationship between cTnI level and the severity of coronary artery lesions.Methods1. Objectives1. 1 Patient; 125 in-patients of angina pectoris from March, 2001 - June, 2002, all diagnosed by criteria of coronary heart disease from WHO, and is divided into two groups; (1)UA group; 91 cases, 66 males and 25 females, age 40-79; (2)SA group; 34 cases, 23 males and 11 females, age 42-75.1.2 Control group; 20 cases from routine health examination, who are generally healthy, 11 males and 9 females, age 40 -65.2. Study method2.1 General information: inquire the history, routine physical examination, detect blood lipid and sugar. On the attack of chest pain, record the duration of pain and observe the EGG change. All patients are treated with routine medicine after administration.2. 2 Coronary angiography. 89 UA patients undergo coronary angiography exam. The severity of coronary lesion is evaluated by the following methods; (1)number of lesioned arteries; (2)score of coronary artery stenosis.2. 3 Collection of blood sample and its test Take 4ml venous blood at the reception time and 2 , 3 morning, the samples are cen-trifuged to collect the serum, half of it is used to determine cTnI by the automatic biochemical analyzer from Bechmann, USA. The other serum is used to determine CK-MB by 7170S automatic biochemical analyzer from Hitachi. The highest value of the three samples is chosen to be analyzed.2.4 Determination of cardiac event (1) cardiac event in hospital : AMI after 24h being received in hospital, cardiac death, intractable angina pectoris. (2)cardiac event after hospital; AMI, cardiac death, intractable angina pectoris, coronary revasculation within 9 -12 month after hospitalization.2. 5 Statistic. Quantitative data is expressed in Mean standard deviation ( x + s ) , using student t test to compare between two groups. Qualitative data is analyzed with x2 test The correlation between two variants is tested with linear regression. Hie correlation of cardiac event is tested with Logistic regression. The difference is significant if P <0.05. All data is analyzed with SPSS 11.5 for windows software.Result1. The result of cTnI and CK-MBThe cTnI level of control group is 0. 021±0.017ng/ml, of UA group is 0.118±0. 104ng/ml (43 cases is higher than normal) , of SA group is 0. 039±0. 053ng/ml (4 cases is higher than normal) . The cTnI level of UA group is higher than that of SA and control group ( P < 0. 01) . The cTnI level of SA group has no difference with that of control group (P >0. 05) . There has no difference of CK-MB levels among the three groups ( P > 0. 05 ) . CK-MB of two UA patients is higher than normal range, both are in the high cTnI group.2. Analyze of clinical data of UA groupAccording to the cTnI level, the UA group is subdivided into normal cTnI (cTnI <0.1ng/ml) and high cTnI group (cTnI>0.1ng/ ml) . Between these two groups, there is no difference in age, sex, cigarettes smoking, cardiac infarction history, diabetes mellitus history, hypertension, hyperlipemia, duration of chest pain. The Braun-wald III patients in high cTnI group is much more than that in the normal cTnI group (P<0.01) .3. The severity of coronary artery lesion and revasculation of UA group89 UA patients undergo coronary angiography. There is no difference between number of lesioned artery and score of coronary artery stenosis ( P > 0.05 ) . Using linear correlation analysis, th... |
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