The Diagnostic Value And The Relationship With The Degree Of Coronary Artery Lesions Of Joint Detection Of Copeptin、cTnI And NT-proBNP In AMI

Background:Acute myocardial infarction (AMI),what has been affecting the quality of human life and serious harm to human life and health.has become one of the common diseases.and it’s morbidity and mortality are on rise within the scope of the world year by year, this is also our country is facing severe challenges. The existing medical assistance diagnostic techniques (electrocardiogram (ECG), echocardiogram, nuelide myocardium imaging, etc.) because of the defects existing in it and can not be timely, accurate assisted the doctor to make a diagnosis and then for further treatment. Currently used in clinical myoeardial necrosis markers, also because of creatine phosphate kinase isoenzyme (CK-MB), troponin time late, also can’t meet the needs of modern medicine. So, find a quick, simple, sensitive myocardial ischemia and necrosis markers is particularly crucial.C-terminal portion of pro-vasopressin (Copeptin) is one of the new discovery of myoeardial necrosis markers, and has been listed as one of the most potential cardiac markers by the U.S. National Institute of Clinical Biochemistry.At present, the domestic reports is few about it.Objective:Discussed the value in early diagnosis of AMI with Copeptin, Cardiac troponin I(cTnI), N-terminal pro brain natriuretic peptide (NT-proBNP); discussed the relationship between the severity of coronary artery lesions with Copeptin, cTnI. NT-proBNP.Methods:To select97patients with chest pain within4hours in shanxi medical university first hospital, respectively from each patient chest pain after4h,6h,12h and24h elbow venous blood.blood plasma was collected by centrifugation, saved to-70degrees Celsius.and determinated the plasma concentration of Copeptin、cTnI、 NT-proBNP,and each patient accepted Coronary angiography (CAG) in each line7-14days after admission.according to the results of CAG, divided into coronary angiography showed no obvious abnormal group (control group),single-vessel disease group,double vessel disease group,three lesions group, left main lesion group.compare the changes of plasma concentration of Copeptin, cTnI, NT-proBNP in different time and different groups.Results:After admission.13patients who were excluded coronary heart disease (CHD) combined with clinical and CAG showed no obvious abnormalities(lesions <50%)(control group).84patients with AMI,the AMI patients were significantly higher than control group in plasma concentration levels of Copeptin, cTnl and NT-proBNP(p<0.05),84patients with AMI were divided into single-vessel disease group of29cases, double vessel disease group of31cases, three lesions group of17cases,left main lesion group of7cases according to the result of CAG,the left main lesion group significantly higher than single-vessel disease groupn double vessel disease group and three lesions group in the plasma concentration levels of Copeptin and NT-proBNP(p<0.05), double vessel disease group and three lesions group were significantly higher than the single lesion group (p<0.05), but double vessel disease group and three lesions group are not statistically significant difference(p>0.05); the plasma concentration levels of cTnl were not statistically different between different lesion Groups in AMI patients (p>0.05);ROC curves analyzed the area under the curve (AUC) of Copeptin, cTnI and NT-proBNP were0.993(P<0.05),0.821(P<0.05).0.857(P<0.05).the Copeptin rise time is earlier than cTnl and NT-proBNP. Conclusion:Copeptin has better clinical value than cTnl and NT-proBNP in the early diagnosis of acute myocardial infarction (sensitivity of Copeptin (%)=0.988, sensitivity of cTnI (%)=0.905. sensitivity of NT-proBNP (%)=0.852);and Copeptin has the equal value with NT-proBNP in the evaluation of severity of coronary artery lesions.