| Objective: Always typical of acute myocardial infarction (AMI) diagnosis based on clinical features, ECG and enzymatic (such as CK-MB,LDH) changes, however, these years many untypical myocardial infarction, relying solely on the above targets will be very difficult to make the diagnosis. This gives difficulties in the early treatment of thrombolytic therapy for the acute myocardial infarction and it also affects the prognosis of myocardial infarction. Therefore, there is an urgent need for a sensitive and highly specific marker for early diagnosis of acute myocardial infarction so as to give a reasonable and timely treatment. In this paper we analyze the changes of serum cTnT and the relationship with diagnosing of angina pectoris or acute myocardial infarction. We will compare the serum cTnT with ECG and enzymatic changes to make the application of serum cTnT in diagnosing AMI. Currently the reperfusion therapy has become the main treatment in acute myocardial infarction. Particularly intravenous thrombolytic therapy has become the treatment of choice for acute myocardial infarction. For the thrombolytic losers PTCA remedies can save the infarct-related artery and benefit the patients a lot. Therefore, the judgment of coronary reperfusion is very important. The function of serum cTnT after judges the myocardial infarction dissolve the hitch the coronary artery whether passing again also needs to be appraised. In addition, the prognosis of unstable angina pectoris (UAP) depends on the degree of coronary lesions. The stable are easily prone to AP, while the unstable are prone to myocardial infarction and sudden death. Thus it plays a vital role for the prognosis of patients with UAP to screen the high-risk patients as soon as possible and provide them an appropriate and timely treatment.cTnT is T preliminary unit of the troponin compound in the skeletal muscle, the cardiac muscle cell and the original textile fiber, cTnT existences in cardiac muscle cell by structure protein and cell liquid soluble protein two kind of forms in cardiac muscle. Former accounts for 95%, latter accounts for 5%.In cardiac muscle cell membrane integrity situation, cTnT cannot penetrate the cell membrane, cTnT is not measured nearly in normal serum. While cardiac muscle cell damage, the massive cTnT release and enter circulation through the intercellular substance. cTnT can detect damage to the small and coronary infarction and the slight myocardium in coronary artery , cTnT is high sensitive. Thus it has very important value to understand whether cTnT can predict UAP or not.Research object and method: To collect the AMI and UAP cases. Unintentionally the antipathy health is the comparison group, separately from flaring up of disease (the early time: In 24h, inter media test age: 3-5 day, later period: In 8-12 day, whether accompanies has heart failure, arrhythmia, the electrocardiogram change, dissolves the hitch with not to dissolve the hitch, after dissolves the hitch treatment whether passes and the age aspect again, comparing the value change of cTnT and CK-MB in the blood serum, analyzing cTnT and the above target having the relevance or not.Results:1.The relations between blood serum cTnT, CK-MB dynamic change and angina pectoris: UAP compared with the healthy control group early cTnT is significantly higher , there are difference between them. At the disease flaring up early stage, midterm, later period, the cTnT value is obviously higher than the comparison group , there are significantly difference between them(p<0.01). At the disease flaring up midterm, the CK-MB value in the AMI group is higher than the control group , they have significantly difference (p<0.01). At the early time, the CK-MB value in the AMI group is higher than the control group , there are difference between them (p<0.05). At later period, there is no difference between them. At the disease flaring up early stage, blood cTnT in AMI group is significantly higher than UAP group, there are obviously difference (p<0.01). At early stage and midterm, blood CK-MB level in AMI group ishigher than UAP group.The two group have significantly difference (p<0.01). At the later period, AMI group is a little higher than UAP group. The results indicate that at the early stage cTnT have more significance to diagnose the AMI.2. The relationship cTnT and CK-MB level with AMI group and UAP group whether have or not heart failure. At early stage, the cTnT level in AMI group with heart failure is higher than without heart failure. They have difference (P <0.05), but blood CK-MB values and congestive heart failure in patients with congestive heart failure are no significant differences (P >0.05).3. The relation between cTnT, CK-MB level and AMI group, UAP group whether have arrhythmia or not. At later period, the cTnT in the AMI group with arrhythmia is higher than the health control group. There are significantly difference between them, but whether the patients have arrhythmia or not, their blood serum CK-MB has no obvious difference.4.The function of blood cTnT, CK-MB value for diagnosing the AMI group and UAP group whether have electrocardiogram change shows that: No matter how low the summit number change in AMI patients group and UAP patients group ,two group have significantly difference. CK-MB summit number in smooth again group is lower than obstructed group, there are significantly difference between them. The summit number time is clearly sooner than obstructed group.5. Disparity in age section AMI group, UAP group and health control group cTnT and CK-MB value change comparison: In the AMI group and the UAP group the low age group (40-50 years old) the cTnT value although compares the advanced age group (51-60 years old) to be high, but two groups have no remarkable difference(p > 0.05); health group in low age group and advanced age group cTnT value and CK - MB value are quite, two group have no remarkable difference (p > 0.05).6.The situation of blood cTnT, the CK-MB value change of AMI group who dissolve the hitch treatment or have not given dissolved the hitch treatment: The blood cTnT of the AMI group who hove not dissolved the hitch treatment is significantly higher than the dissolved group, two group have remarkable difference(p<0.01)7. The situation of illness blood cTnT and the CK-MB value change case of the AMI group that dissolves ties up fills again and that don't pass: The blood serum cTnT change of AMI group assume the split-blip release curve, the first early summit number happens about after the myocardial infarction happening 10-14 hours, the second summit number happens about after myocadial infarctin happening 80-100 hours. The patients who have dissolved but obstructed blood vessel have only one summit number with the time passing by, it happens about at the myocadial infarction happening 56-80 hours , it happens sooner than the patients who have been dissolved the blood vessel . According to the high of the cTnT summit, the height of the smooth again group, summit number is lower than the obstructed group , they have significantly difference. The CK-MB summit of the smooth group is lower than the obstructed group , there are significantly difference between them, the summit time of the smooth group happens obviously sooner than the obstructed group.Conclusion:1.Blood cTnT value is more sensitive than CK-MB in the AMI diagnosis.2.Blood cTnT value can be specific index for diagnosing early AMI3.Blood cTnT value is a sensitive index for diagnosing whether the AMI with or without heart failure .4.Blood cTnT value has not demonstrated the specificity for diagnosing the AMI in arrhythmia and the change of ECGsection are not remarkable different.5.Blood serum cTnT value change may reflect the situation of AMI patient that dissolves the hitch to pass.
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