血清CK、CDH、AST检测在骨筋膜室综合征早期诊治中的应用观察

Application of CK,LDH and AST in early diagnosis of compartment syndrome

目的动态检测骨筋膜室综合征患者血清磷酸肌酸激酶(CK)、乳酸脱氢酶(LDH)、天冬氨酸氨基转移酶(AST)水平,探讨其在骨筋膜室综合征早期诊断及病情评估中的作用。方法选择四肢骨筋膜室综合征的患者40例,在伤后2、24h及1、2、3、4周动态检测血清CK、LDH、AST。在术中以及术后1、2、3周取患肢受累肌肉组织行病理检查。结果伤后2h时,患者血清CK、LDH、AST水平急剧升高,分别为正常值的20、2、4倍,24h时达峰值,CK、LDH和AST分别为正常值的42、4、10倍;1周时,LDH、AST依然高于正常值(P均<0.05)。病理显示肌肉标本明显坏死,呈不可逆性变化。结论CK、LDH、AST的变化能客观反映骨筋膜室综合征的病情严重程度。当这些指标急剧升高时要高度警惕骨筋膜室综合征的发生。动态监测这些指标可为骨筋膜室综合征的早期诊断及病情评估提供帮助。

Objective To determine the efficacy of CK, LDH and AST in the early diagnosis of compartment syndrome and assessment of pathegenetic condition. Methods 40 cases of compartment syndrome were collected,CK,LDH and AST were measured dynamically after injury at 2,24 h, and 1,2,3 and 4 weeks in aU subjects. The muscle preparations were taken at from affected limb operation and 1,2 and 3 weeks after the operation for pathologic diagnosis. Results At 2 h after injury, the level of CK, LDH and AST increased sharply and achieved respectively about 20,2 and 4 times more than the normal. At 24 h,the level of CK,LDH and AST reached its maximum about 42,4 and 10 times more than the normal. The level of LDH and AST were still high, compared to the normal at 1 week （ all P 〈 0.05 ）. Pathological changes of muscle were irreversible. Conclusion The level of C K,LDH and AST can reflect the progression of disease objectively. It is suggested that monitoring this markers dynamicly may provide assistant for early diagnosis of compartment syndrome and evaluation of patients condition.