CAJ | 학술논문

目的探讨糖原磷酸化酶同工酶脑型(GPBB)在急性心肌梗死(AMI)早期诊断中的价值.方法选择115例发病6 h内的胸痛患者,其中AMI患者45例(AMI组),非AMI患者70例(非AMI组).非AMI组中不稳定型心绞痛(UAP)40例、稳定型心绞痛(SAP)13例、非心源性胸痛17例;选择55例健康体检者作为健康对照组.检测发病0～6 h的血浆GPBB水平,并与心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶-MB(CK-MB)和肌红蛋白(MYO)的检测结果进行比较,分析上述指标诊断发病0～3 h和0～6 hAMI的灵敏度、特异度和准确度.结果在O～3 h和0～6 h时间段,GPBB诊断AMI的灵敏度(64.29%、88.89%)显著高于cTnI(28.57%、60.00%)和CK-MB(21.43%、64.44%),P均<0.05;与MYO(71.43%、77.78%)比较差异无统计学意义.上述指标特异度差异无统计学意义.在0～3 h和0～6h时间段GPBB诊断AMI的准确度(80.77%、89.57%)显著高于cTnI(61.54%、81.74%)、CK-MB(50.00%、75.65%)和MYO(73.08%、73.91%),P均<0.05.结论 GPBB对于诊断早期AMI具有较高的灵敏度和特异度,其诊断准确度优于cTnI、CK-MB和MYO.
목적 탐토당원린산화매동공매뇌형(GPBB)재급성심기경사(AMI)조기진단중적개치.방법 선택115례발병6 h내적흉통환자,기중AMI환자45례(AMI조),비AMI환자70례(비AMI조).비AMI조중불은정형심교통(UAP)40례、은정형심교통(SAP)13례、비심원성흉통17례;선택55례건강체검자작위건강대조조.검측발병0～6 h적혈장GPBB수평,병여심기기개단백Ⅰ(cTnI)、기산격매동공매-MB(CK-MB)화기홍단백(MYO)적검측결과진행비교,분석상술지표진단발병0～3 h화0～6 hAMI적령민도、특이도화준학도.결과 재O～3 h화0～6 h시간단,GPBB진단AMI적령민도(64.29%、88.89%)현저고우cTnI(28.57%、60.00%)화CK-MB(21.43%、64.44%),P균<0.05;여MYO(71.43%、77.78%)비교차이무통계학의의.상술지표특이도차이무통계학의의.재0～3 h화0～6h시간단GPBB진단AMI적준학도(80.77%、89.57%)현저고우cTnI(61.54%、81.74%)、CK-MB(50.00%、75.65%)화MYO(73.08%、73.91%),P균<0.05.결론 GPBB대우진단조기AMI구유교고적령민도화특이도,기진단준학도우우cTnI、CK-MB화MYO.
Objective To evaluate the value of glycogen phosphorylase isoenzyme BB (GPBB) in the diagnosis of early acute myocardial infarction (AMI). Methods The plasma levels of GPBB were mea-sured by sandwich ELISA in 115 patients with suspected AMI at admission within 6 hours after onset of chest pain and 55 normal healthy subjects. The plasma concent of cardiac troponin-Ⅰ (cTnI), creatine kinase-MB (CK-MB) and myoglobin (MYO) was assayed at the same time by using corpuscle chemiluminescence. The patients were classified retrospectively into AMI group (n = 45) , unstable angina pectoris (UAP) group (n =40) , stable angina pectoris (SAP) group (n = 13) and non-cardiac chest pain (NCCP) group (n =17).The diagnostic validity was evaluated in terms of sensitivity and specificity. Results The diagnostic sensitivity of GPBB for AMI was 64.29 % within 3 hours and 88.89 % within 6 hours after onset of chest pain,which is significantly higher than that of cTnI (28.57 %, 60.00 %) and CK-MB (21.43 %, 64.44 % ). There was no significant difference in specificity among the four markers. The diagnostic accuracy of GPBB within 3hours and 6 hours (80.77 %, 89.57% ) was significantly higher than that of cTnI (61.54%, 81.74% ),CK-MB (50.00%, 75.65%) and MYO (73.08% ,73.91%). Conclusions GPBB seems to be a sensitive and specific biochemical cardiac marker for AMI in the early stage. Its diagnostic accuracy is higher than that of cTnI, CK-MB, MYO.