The Diagnostic Value Of Dynamic Changes Of Myocardial Damage Markers And C-reactive Protein In Patients With Acute Myocardial Infarction

Objective To explore the diagnostic value on serum myocardial damage markers and C-reactive protein of the dynamic changes in acute myocardial infarction (AMI).Methods The serum cTnI,CK-MB and Mb of 40 patients with AMI at different times were determined by enzyme-linked immunosorbent assay(ELISA),Forty healthy subjects servered as controls.At the same time the serum concentration of cTnI,CK-MB and Mb were analysised by receiver operating characteristic(ROC) curve.And the concentration of high-sensitivity C-reactive protein(hs-CRP) was measured in 40 patients with AMI by ELISA method,and compared with control group and 40 patients with unstable angina pectoris(UAP).Results①The serum cTnI,CK-MB and Mb concentration of AMI patients after the onset of chest pain at different times were higher than that of the control group(F= 72.679,109.768,q=3.049-27.652,P＜0.01).The concentration changes of different time after onset of chest pain had also significant difference(F=72.679,109.768,q= 2.863-22.133,P＜0.05,0.01).The serum Mb concentration of chest pain onset after 3-6h,24h was significantly higher than that of chest pain onset after 3 days and 7 days(F =17.729,q=6.175-8.688,P＜0.01).The sensitivity,specificity,accuracy,Yuedeng index,positive predictive value(PPV)and negative predictive value(NPV) of CK-MB, cTnI to diagnosis of AMI were significantly higher than that Mb.The diagnosis accuracy of serum CK-MB was higher than cTnI and Mb,when patients chest pain onset after 3 to 6h.The diagnosis accuracy of serum cTnI and CK-MB of 24h and 3d were the same,but better than Mb.Chest pain onset after 7 days the diagnosis accuracy of cTnI to AMI was better than CK-MB.The area under the ROC curve(AUC^ROC) of CK-MB and cTnI were higher than Mb,when chest pain onset after 3-6h and 24h.The AUC^ROC of cTnI was higher than CK-MB,when chest pain onset after 7 days.And different times of the AUC^ROC of CK-MB and cTnI are greater than 0.9.②The concentration of hs-CRP in patients with AMI was higher than that of the control group and patients with UAP(F= 40.487,q=11.884,9.883,p＜0.01).Conclusion The dynamic changes of CK-MB,cTnI and Mb concentration had obvious value and higher accuracy on the the diagnosis of AMI.The changes of hs-CRP concentration had predictive value on the incidence of major cardiac events.