非心源性疾病患者MB型肌酸激酶活性假性升高原因分析

Analysis of the causes of false increase in serum MB form creatine kinase activity and its clinical value

目的:探讨非心源性疾病患者血清中MB型肌酸激酶(CK-MB)活性假性升高的原因及其与疾病的关系。方法:对日常采用免疫抑制法检测的CK-MB活性高于正常参考值(0～25U/L)、与肌酸激酶(CK)比值>0.38的55例标本进行CK同工酶琼脂糖凝胶电泳分析;1周后重取标本检测CK-MB,并与开始的CK-MB值进行比较,结合临床诊断进行分析。结果:55例患者根据临床诊断,其中恶性肿瘤41例(肝癌16例、肺癌11例、前列腺癌7例,其他肿瘤7例),肝硬化12例,其他2例;CK-MB含量百分比均<5%,其中34例恶性肿瘤检出线粒体型肌酸激酶(m acro-CK2),23例恶性肿瘤检出BB型CK(CK-BB),16例恶性肿瘤同时检出巨CK2和CK-BB。12例肝硬化患者均检出巨CK2。前后2次CK-MB活性浓度进行比较,变化差异无统计学意义(P>0.05)。结论:血清CK-MB活性的假性升高,主要是由于血液中出现了异常升高的CK-BB或巨CK(巨CK1、巨CK2);它们的出现与肝硬化及某些恶性肿瘤密切相关。

Objective：To discuss the cause of false increase in serum MB form creatine kinase（CK-MB） activity in non-cardiogenic patients and its relationship to the disease.Methods：The creatine kinase isoenzyme in the routine specimen of 55 patients whose CK-MB activities were higher than the reference level（25 U/L）and the ratio to creatine kinase（CK）were more than 0.38 were determined using agarose gel electrophoresis.One week later,the CK-MB was determined again and the results were compared with the original values.The analysis was performed combining the clinical diagnosis results.Results： Forty-one of the 55 patients was diagnosed as malignant tumors（16 liver cancer,11 lung carcinoma,7 prostate carcinoma,7 other tumors） and 12 patients as liver cirrhosis;Creatine kinase isoenzyme and the contents of CK-MB of the patients were all less than 5%;Macro-CK2 was detected in 34 cases of malignant tumors,and CK-BB was detected in 23 cases of malignant tumors.Both macro-CK2 and CK-BB were detected in 16 cases of Malignant tumors;Macro-CK2 was detected in 12 cases of liver cirrhosis.Comparison was made between the CK-MB active concentrations detected in the two times.No significant variation was observed（P0.05）.Conclusions：The false increase in serum CK-MB activity is mainly caused by the abnormal increase of CK-BB or macro-CK（macro-CK1,macro-CK2） in blood;their appearance is closely related to liver cirrhosis and certain malignant tumors.