肌酸磷酸激酶及其同功酶MM协助诊断异位妊娠的价值

The diagnostic value of creatine phosphokinase and its MM isoenzyme fraction in ectopic pregnancy

目的探讨肌酸磷酸激酶(CPK)及其同功酶CPK-MM在诊断异位妊娠中的价值。方法收集异位妊娠的病人112例作为研究对象,另取同期不全流产患者100例及正常宫内妊娠100例作为对照。入选后即抽取静脉血化验其血清肌酸磷酸激酶(CPK)及其同功酶CPK-MB和CPK-MM;异位妊娠组手术后24h,难免流产组诊刮后24h再抽取静脉血进行同样化验,将上所有标本进行相关统计分析。结果异位妊娠组其首次血清CPK值、CPK-MM值、CPK—MM所占百分数(CPK—MM%值)均明显高于两个对照组(P<0.05)。异位妊娠组首次血清的CPK-MB值高于难免流产组(P<0.05),而CPK—MB所占百分数(CPK-MB%值)低于两个对照组(P<0.01)。CPK和CPK-MM单项检测的ROC-AUC分别为0.96和0.96;当CPK≥28.5(U/L)时,诊断异位妊娠灵敏度和特异度分别为91.1%和88.7%;CPK-MM≥24.5(U/L)时,诊断异位妊娠灵敏度和特异度分别为91.1%和93.7%。结论肌酸磷酸激酶CPK及其同功酶CPK-MM有助于异位妊娠的诊断。

Objective To investigate the diagnostic value of creatine phosphokinase（CPK）and its MM（CPK-MM）isoenzyme fractions in ectopic pregnancy.Methods One hundred and tweleve women with ectopic pregnancy,one hundred with intrauterine abortive gestation,and one hundred regular pregnant women（controls）were studied.Serum total CPK,CPK-MB,and CPK-MM levels were measured at the time of presentation and 24 hour after surgery.Relative operating characteristic（ROC）curves were plotted.Results The CPK and CPK-MM levels and CPK-MM relative ratio（CPK-MM%）were significantly higher in ectopic pregnancy compared with intrauterine abortive gestation and regular pregnancy.The ROC curves demonstrated a significant discriminatory ability of increased total CPK and CPK-MM for the diagnosis of ectopic pregnancy.Conclusion Determination of total maternal CPK and its CPK-MM isoenzyme fraction can significantly enhance the diagnostic value in the prediction of ectopic pregnancy.