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罗纯生1 展秀君2 张俊玮2 王艳荣2 郝振伟2.生化检测中肌酸激酶同工酶高于肌酸激酶的原因及对病情、心肌损伤程度的诊断分析[J].中国现代医生,2021,59(11):88-91
生化检测中肌酸激酶同工酶高于肌酸激酶的原因及对病情、心肌损伤程度的诊断分析
Reason analysis of creatine kinase isoenzyme higher than creatine kinase in biochemical test and the diagnosis analysis of the conditions and the degree of myocardial damage
  
DOI:
中文关键词:  生化检测  肌酸激酶同工酶  肌酸激酶  病情程度  心肌损伤
英文关键词:Biochemical testing  Creatine kinase isoenzyme  Creatine kinase  Degree of disease conditions  Myocardial injury
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作者单位
罗纯生1 展秀君2 张俊玮2 王艳荣2 郝振伟2 1.黑龙江省佳木斯市中心血站黑龙江佳木斯 1540002.黑龙江省佳木斯市中医院黑龙江佳木斯 154000 
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中文摘要:
      目的 分析生化检测中肌酸激酶同工酶高于肌酸激酶的原因及对病情、心肌损伤程度的诊断。方法 随机抽取我院在2017 年3 月至2018 年3 月收治的行生化检测3125 例患者,采集所有患者的肌酸激酶同工酶(CK-MB)与肌酸激酶(CK)标本,其中CK-MB 高于CK30 例(0.96%),分析CK-MB 高于CK 的原因,同时在观察监测CKMB、CK 及变化情况对心肌损伤程度的影响。结果 检测发现,0~3 岁患儿CK-MB 高于CK 检出16 例(4.13%,16/387),恶性肿瘤患者CK-MB 高于CK 检出9 例(8.57%,9/105),其他疾病患者CK-MB 高于CK 检出5 例(0.19%,5/2633),且0~3 岁患儿CK-MB 值更高,恶性肿瘤患者在CK-MB 高于CK 的检测中占比更多。心肌损伤在发生后2~72 h 的CK、CK-MB 均呈现不同变化,CK 在12 h 时达到峰值,CK-MB 在4 h 时达到峰值,之后则呈现持续下降趋势,同时心肌损伤者CK 所需达峰时间更长,即CK 会比CK-MB 检测值后达到最大检测值,CK-MB的即刻升高倍数、峰值升高倍数较CK 更大,即CK-MB 检测数据变化较大,会有急剧上升现象。结论 在临床生化检测中导致CK-MB 高于CK 的主要原因可能与患者年龄、疾病以及检测方式等存在密切关系,同时CK、CKMB 水平变化能够作为诊断心肌损伤程度的指标,以便临床了解患者病情发展情况来制订更为安全有效的治疗方案。
英文摘要:
      Objective To analyze the reason why creatine kinase isoenzyme is higher than creatine kinase in biochemical testing and the diagnosis of disease conditions and myocardial damage.Methods A random sample of 3 125 patients who underwent biochemical testing in our hospital from March 2017 to March 2018 were randomly selected.Creatine kinase isoenzyme (CK-MB) and creatine kinase (CK) specimens were collected from all patients.Among them,CK-MB was higher than CK in 30 cases (0.96%).The reason why CK-MB was higher than CK was analyzed.At the same time,the influence of CK-MB,CK and changes on the degree of myocardial injury were observed and monitored.Results According to the testing results,CK-MB was higher than CK in 16 cases of children aged 0-3 years (4.13%,16/387).Malignant tumor patients with CK-MB higher than CK were detected in 9 cases (8.57%,9/105).CK-MB of patients with other disease was higher than CK in 5 cases (0.19%,5/2633),and children patients aged 0-3 years showed higher CK-MB values.Among the testing results with CK-MB higher than CK,patients with malignant tumors showed a higher proportion.Myocardial injury showed different changes in CK and CK-MB 2-72 h after occurrence.CK peaked at 12 h,and CK-MB peaked at 4 h.After that,it showed a continuous downward trend.At the same time,patients with myocardial injury required a longer CK peak time.Namely,CK reached the maximum testing value after the CK-MB value reached the maximum.The immediate rise multiples and peak rise multiples of CK-MB were greater than those of CK.Namely,the testing data of CK-MB changed greatly,and there showed a sharp rise.Conclusion The main reason that CK-MB is higher than CK in clinical biochemical testing may be closely related to the patient′s age,disease conditions,and testing methods.At the same time,changes in the levels of CK and CK-MB can be used as indicators for the diagnosis of myocardial damage,which facilitates clinical understanding of the patient′s condition and development of a safer and more effective treatment plan.
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