The diagnostic value of using three kinds of serum myocardial injury markers to detect acute coronary syndrome / 中国基层医药

ABSTRACT

Objective To discuss the clinical value of using three markers including ischemia modified albu-min (IMA),N terminal brain natriuretic peptide precursor (NT -proBNP)and allergic troponin I (TnI -Ultra)in diagnosis of acute coronary syndromes (ACS).Methods 80 ACS patients diagnosed by coronary artery imaging were selected,and meanwhile 80 healthy people were chosen as the control group.The serum IMA,NT -proBNP and TnI -Ultra were recorded and compared.The changes of IMA,NT -proBNP and TnI -Ultra in all ACS patients the chest pain onset time,chest pain <3h within and between 3 -6h serum were recorded and compared;And sensitivity,specif-ic and accuracy diagnosis in ACS of the three separate tests and joint detection were compared.Results In ACS patients,serum IMA,NT -proBNP and TnI -Ultra were all significantly higher than those in the control group (t =14.62,25.08,35.77,all P <0.05).In UA,NSTEMI,STEMI patients,serum IMA,NT -proBNP and TnI -Ultra all had statistically significant differences (F =10.89,29.08,40.33,all P <0.05);And in NSTEMI,STEMI patients, serum NT -proBNP and TnI -Ultra were significantly higher than those in patients with UA (all P <0.05 );In STEMII patients,serum NT -proBNP and TnI -Ultra were significantly higher than those in the NSTEMI patients (all P <0.05).In patients chest pain less than 3h,chest pain patients'serum IMA,3 -6h NT -proBNP and TnI -Ultra were significantly higher than those in the control group (all P <0.05);In chest pain less than 3 -6h patients,serum IMA,NT -proBNP and TnI -Ultra were significantly higher than those in chest pain less than 3h patients (all P <0.05).The positive detection rate of IMA,NT -proBNP and TnI -Ultra joint detection was 95.0% (76 /80),which was significantly higher than that of the single detection (P <0.05 ).Conclusion IMA,NT -proBNP and CTnI combined detection could significantly improve the sensitivity and accuracy of the early diagnosis of ACS,which testing cycle is short and easy to operate,worthy of clinical promotion.