深圳宝安区不同年龄健康儿童血清中CK-MB正常值参考区间的建立

The establishment of normal reference range for serum CK-MB of healthy children in different age in baoan district of Shenzhen

目的:建立深圳宝安区不同年龄健康儿童血清中肌酸激酶同工酶MB(CK-MB)正常值参考区间,为本地区儿童心肌损伤的诊断提供科学依据。方法:采用数表法随机选取2016年2月至2017年1月在医院体检的健康儿童3176名,按年龄分为<1岁、1~3岁、4~6岁和7~15岁4组,并选择同期18~50岁健康成年人1549名,分别采用免疫抑制法检测血清中CK-MB含量,并对数据进行统计分析,CK-MB浓度水平呈偏态分布,采用百分位数(P95)作为参考区间的单侧上限,确定本区相应的生物参考区间,并比较分析不同年龄和性别儿童血清中CK-MB浓度水平之间的差异性。结果:同年龄的4组儿童男性与女性血清中CK-MB浓度水平比较,差异无统计学意义(t=1.293,t=0.962,t=0.529,t=0.415;P>0.05)。4组儿童血清中CK-MB浓度水平检测,<1岁组明显高于其他3组儿童,差异有统计学意义(t=5.915,t=12.657,t=8.615;P<0.05);1~3岁组高于4~6岁组和7~15岁组,差异有统计学意义(t=3.092,t=3.781;P<0.05);而4~6岁组与7~15组之间差异无统计学意义(t=1.385,P>0.05)。健康成年人组血清中CK-MB浓度水平明显低于健康儿童组,差异有统计学意义(t=13.592,P<0.05)。<1岁组、1~3岁组和4~15岁组健康儿童血清中CK-MB正常值参考区间分别为0~58 U/L、0~45 U/L和0~37 U/L。结论:深圳宝安区健康儿童CK-MB浓度水平与性别无关,而与年龄相关,且随着年龄增长CK-MB水平呈下降趋势。建立本区不同年龄儿童血清中CK-MB正常值参考区间,可为儿童心肌损伤的诊断提供科学依据。

Objective： To establish the normal reference range of serum creatine kinase isoenzyme MB（CK-MB） for healthy children of different age in Baoan district of Shenzhen so as to provide scientific reference for the myocardial injury of children in this district. Methods： 3176 cases were selected from healthy children received physical examination since February 2016 to January 2017 as random number table and they were divided into four groups as age stage（1 year old, 1-3 years old, 4-6 years old and 7-15 years old）. Besides, 1549 healthy adults（18-50 years old） were selected in the research. The CK-MB concentration in all of these cases were detected by immune suppression method, and the statistical analysis of these data revealed that the concentration level of CK-MB was skewed distribution. The P95 was determined as the up limit of unilateral in the reference interval, and then the relevant biological reference range was determined as above data. The concentration of CK-MB among different age stages and that of CK-MB between different genders were compared. Results： In every age group, the difference of concentration of CK-MB between male and female was no significant（t=1.293, t=0.962, t=0.529, t=0.415, P〉0.05）. In the four groups, the concentration of 〈1 year group was significantly higher than other three groups（t=5.915, t=12.657, t=8.615, P〈0.05）. And the group of 1-3 years old was significantly higher than group of 4-6 years old and group of 7-15 years old（t=3.092, t=3.781, P〈0.05）, respectively. While the difference of concentration between group of 4-6 years old and group of 7-15 years old was no significant（t=1.385, P〉0.05）. Besides, the concentration of healthy adult was significantly lower than that of healthy children（t=13.592, P〈0.001）. The normal reference interval of group of 〈1 years old, group of 1-3 years old and group of 4-15 years old were（0-58）U/L,（0-45）U/L and（0-37）U/L, respectively. Conclusion： The concentration of CK-MB in healthy children of Baoan district is not correlative with gender while it is correlative with age. Besides, the concentration of CK-MB is decreased with the increasing of age. To establish the normal reference range of serum CK-MB for children in different age stage can provide science reference for the diagnosis of myocardial injury in children.