Application value of combined detection of troponin I, creatine kinase isoenzyme mass, interleukin-6 and fibrinogen degradation products in the diagnosis and treatment monitoring of acute myocardial infarction / 中国医师进修杂志

ABSTRACT

Objective:To explore the application value of combined detection of troponin I (cTnI) and creatine kinase isoenzyme mass (CKMBmass), interleukin-6 (IL-6) and fibrinogen degradation products (FDP) in the diagnosis and treatment of acute myocardial infarction (AMI).Methods:A total of 102 AMI patients in Wanbei Coal Power Group General Hospital from July 2019 to June 2020 were selected as the AMI group. In addition, 60 patients diagnosed with chest pain (CP) and chest distress (CD) during the same period were selected as the CPCD group, and 60 healthy patients were selected as the healthy control group. The levels of cTnI, CKMBmass, IL-6 and FDP in the peripheral blood of the three groups were compared, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of cTnI, CKMBmass, IL-6, and FDP. The AMI group was given thrombolytic therapy. The clinical data of patients with different curative effects, the trend of changes in peripheral blood cTnI, CKMBmass, IL-6 and FDP levels before and after treatment were compared, and the relationship between the above indicators and clinical indicators and curative effects were analyzed.Results:The levels of peripheral blood cTnI, CKMBmass, IL-6 and FDP in the AMI group were higher than those in the CPCD group and the healthy control group, and the levels of peripheral blood cTnI, CKMBmass, IL-6 and FDP in CPCD group were higher than those in the healthy control group ( P<0.05). The area under the curve (AUC) values of cTnI, CKMBmass, IL-6 and FDP in the combined diagnosis of CPCD and AMI were 0.898 and 0.926, respectively, which were higher than those of single diagnosis. The time from onset to thrombolysis, infarct location, diabetes, diastolic blood pressure (DBP), systolic blood pressure (SBP), left ventricular end systolic volume (LVESV), left ventricular end systolic diameter (LVESD), left ventricular end diastolic volume (LVEDV), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) on admission of effective patients and ineffective patients were statistically significant ( P<0.05). The levels of peripheral blood cTnI, CKMBmass, IL-6, and FDP of effective patients were lower than those of ineffective patients when they were admitted to the hospital and 6, 12, 24, 48, and 72 h after treatment ( P<0.05). The peripheral blood cTnI, CKMBmass, IL-6, and FDP on admission were positively correlated with DBP, SBP, LVESV, LVESD, LVEDD, LVEDV, and was negatively correlated with LVEF ( P<0.05). Multiple linear stepwise regression analysis showed that after the onset to thrombolysis time, infarct location, smoking, diabetes, SBP, DBP, LVESV, LVESD, LVEDD, LVEDV, LVEF and other factors at admission were controlled, the levels of peripheral blood cTnI, CKMBmass, IL-6, FDP were still significantly related to the efficacy ( P<0.05). Conclusions:The peripheral blood cTnI, CKMBmass, IL-6, and FDP are all abnormally expressed in AMI patients. Combined detection has clinical significance for the diagnosis and treatment of AMI.