Establishment of reference range for myeloperoxidase(MPO) determined by bidirectional lateral flow lmmunoassay and MPO for the clinical value of AMI discussion

BAO Jin; SHANG Hong-li; SUN Lu-lu; GAO Hai-di; JIN Yu-ting; HUANG Jing

doi:10.3969/j.issn.1002-266X.2014.41.006

Abstract：Objective To established bidirectional lateral flow immune Myeloperoxidase ( MPO) reference range, de-termine the best diagnostic cut-off value MPO for AMI, evaluate MPO early diagnostic value of patients with AMI, investi-gate the relationship between levels of MPO and prognosis of AMI.Methods Totally 363 health cases were collected from the first hospital of Jilin university medical examination center; all of the 363 plasma specimen MPO concentrations were measured by MPO kits.363 cases of healthy people by age are divided into 6 groups which included less then 30, 30-39, 40-49, 50-59, 60-69 and at the age of 70 or higher.According to the different gender and age, statistical analysis was to execute.The plasma MPO levels of Acute Myocardial Infarction ( AMI) group, Unstable Angina Pectoris ( UAP) group and control group are tested by the MPO kits.The measurement results were statistically analyzed using ROC curves.The patients with high MPO level in AMI group were followed-up by telephone, tracking the relationship between MPO and the prognosis of AMI.Results There was no statistically significant difference of MPO levels in different gender and age groups which was due to the measurement results of MPO skew distribution, taking unilateral 95 percentile values for bidi-rectional lateral flow immune MPO reference range, which is less than 23.10 ng/mL; There were obvious differences of MPO ( P<0.01) which were compared among AMI group and UAP group and control, respectively;the comparison results between AMI group and UAP group were show significant differences (all P<0.01) as well.MPO in the area under the ROC curve is 0.761 and the best diagnosis of AMI cut-off value was 28.82 ng/mL.The positive rate of MPO was 0.808 and of cTnI is 0.653 in the 219 cases of AMI patients, separately.There were 50 cases with MPO positive but with cTnI negative.Totally 81 cases of patients with high MPO level were found, 15 cases had a relapse in a half years after the onset of AMI.and 3 cases died.Conclusion Bidirectional lateral flow MPO reference range was less than 23.10 ng/mL, and the best diagnosis of AMI cut-off values was 28.82 ng/mL.MPO has more clinical value for the early diagnosis of AMI. The increase of MPO may be an independent predictor of the risk of serious cardiovascular disease during the follow-up in-teral from one to six months later and it could be more meaningful to the patients especially whose cTnI are false negative.