The Study Of The Joint Detection Of The Serum Level Of GDF-15,HC Gp-39 To Assess The Risk Of Myocardial Infarction

Objective:At present,the morbidity of coronary atherosclerotic heart disease is increasing year by year in the worldwide,as pathological physiology and molecular biology in-depth study recent years,many inflammatory response factor and protect factor is found to have a high clinical risk prediction and prognosis estimate value,both the factors exist in the process of the formation of atherosclerotic plaque in coronary artery,plaque rupture and myocardial injury.GDF-15 has been proved to be involved in stress response after myocardial injury and myocardial protection process.YKL-40 has been proved to play a role in the inflammatory response in the formation of atherosclerotic plaque and process of myocardial injury,and it has been highly expressed in the related inflammatory cells.By observing whether or not the serous GDF-15 and YKL-40 levels increase significantly in acute myocardial infarction patients,to discuss whether or not these two factors have correlativity with the occurrence risk of acute myocardial infarction,in order to explore whether or not the way of jointly testing GDF-15 and YKL-40 is more helpful in assessing the occurrence risk of acute myocardial infarction.Methods:40 patients diagnosed as acute myocardial infarction and certified with atherosclerotic lesion in coronary arteriongraphy from August in 2016 to August in 2017 in our hospital,were selected randomly to act as observation group,and 40 patients in our hospital certified with atherosclerotic lesion in coronary arteriongraphy but without myocardial infarction in the same period were selected randomly to act as control group,both of whom were taken ulnar vein blood 1 hour before the coronary arteriongraphy,then the GDF-15 and YKL-40 levels of each group were measured to compare whether or not the serous GDF-15 and YKL-40 levels of patients in both groups show statistical significance,meanwhile,the specificity and sensibility on detecting acute myocardial infarction by the way of jointly testing two factors and by solely testing one factor were compared.Results:1.The serous GDF-15 level [(669.5±131.6)nmol/L] and the YKL-40 level [(0.984±0.198)nmol/L] in observation group were both significantly higher than the control group,GDF-15 level [(552.8±196.3)ng/L] and YKL-40 level [(0.508±0.159)nmol/L],the difference showed statistical significance(P<0.05)2.The sensitivity on detecting acute myocardial infarction by jointly testing serous GDF-15 and YKL-40 levels was 91.0%,the specificity was 85.0%,the sensitivity by solely testing serous GDF-15 level was 80.0%,the specificity was 85.0%,the sensitivity by solely testing serous YKL-40 level was 82.5%,the specificity was 85.0%;taken the specificity as X-axis and the sensibility as Y-axis,the ROC curve was established,in which the area under jointly testing curve was larger than any area under the solely testing curve.Conclusion:The serous GDF-15 and YKL-40 levels in acute myocardial infarction patients significantly higher than coronary heart disease patients with no myocardial infarction,it is possible that the serous GDF-15 and YKL-40 levels have correlation with the occurrence risk of acute myocardial infarction.The sensitivity and specificity on detecting acute myocardial infarction by the way of jointly testing serous GDF-15 and YKL-40 levels are better than the way of solely testing one factor,which then demonstrated that jointly testing both factors is more helpful in assessing the occurrence risk of acute myocardial infarction.