Early Assessment of Infarct Size by CK,CK-MB and TnT after Reperfusion in Acute Myocardial InfarctionEarly Assessment of Infarct Size by CK,CK-MB and TnT after Reperfusion in Acute Myocardial Infarction
摘要(Abstract)：
<正> Primary PTCA is an effective performance to reopen the infarct-relatedartery,so as to limit infarct size and maintain left ventricular function.It is veryimportant to estimate infarct size for the management and prognosis after AMI.Infarct size can be assessed by serum creatinc phosphokinase (CK).CK isoenzymeMB (CK-MB) or troponin T (TnT),but reperfusion therapy such as primary PTCAhas a washout effect on these biochemical indexes.Whether or not thesebiochemical indexes are still useful in estimating infarct size after reperfusion isconfused.Objective:To detect the possibility of serum CK,CK-MB and TnT forassessing the infarct size after early successful reperfusion in acute myocardialinfarction (AMI),and find a better method of these biochemical indexes toestimate infarct size.Methods:This study consisted of 29 AMI patients aftersuccessful primary PTCA.Serum CK,CK-MB and TnT were measuredsequentially within 72 hours after primary PTCA,and ~(99m)Tc-MIBI myocardialsingle photon emission computed tomography was performed within 30 days afterpermission to calculate the myocardial infarction score (ISI).The peak,sum totaland area under curve within 16 hours of these biochemical indexes were comparedwith ISI with linear regression analysis and multiple stepwise regression analysis.Finally,the result were correlated with ISI to find its assessed value.sensitivity andspecificity.Results:Serum CK,CK-MB and TnT increased rapidly after primaryPTCA (p<0.05);CK,CK-MB and TnT release curves were about monophasicwithin 24 hours;The peak,sum total and area under curve within 16 hours of CK,CK-MB and TnT correlated well with ISI;The area under curve within 16 hours ofTnT correlated best with ISI (r=0.58,p<0.01),its regression equation was Y=1.39×10~(-4)X+0.20.While patients were grouped by ISl as 30%.there wasobvious difference on the ISI between the 2 groups (p<0.01).The assessing valueof TnT area under curve within 16 hours to infarct size was 85.2% (ISI=30%.TnTAUC=688μg.h/l),the sensitivity was 100%,specificity was 84%.Two of thesepatients studied had a relative normal ~(99m)Tc-MIBI myocardial perfusion as healthypeople.Conclusion:The area under curve within 16 hours after primary PTCAcan be used to assess infarct size in AMI.Primary PTCA can reopen the infarct-related artery in time,and rescue the dying myocardium obviously.
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