肌萎缩侧索硬化患者血清肌酶水平的临床研究

Serum creatine kinase level in amyotrophic lateral sclerosis

目的探讨肌萎缩侧索硬化(ALS)患者血清肌酸激酶(CK)的水平,及其与年龄、性别、病情分级、起病方式、病程之间的关系。方法回顾性分析40例确诊ALS并行血CK检查患者的临床资料,根据性别、年龄、起病部位、病情分级、病程进行分组,统计各组间CK水平的差异。结果本组患者CK为25～562U/L,平均88U/L。15例CK轻度增高。男女性别间CK水平差异无统计学意义(P=0.12),中青年组(<60岁)和老年组(≥60岁)CK水平差异无统计学意义(P=0.85),临床分级轻度、中度、重度、危重组间CK水平差异无统计学意义(P=0.58),病程较短组(<1年)和较长组(≥1年)CK水平差异无统计学意义(P=0.11);球部起病组CK水平明显低于肢体起病组[(109.54±23.40)U/Lvs.(206.13±29.56)U/L,P=0.02]。结论 CK增高在ALS患者中并不少见,肢体起病者CK水平更高,CK水平与年龄、性别、病程、病情分级不相关。

Objective To evaluate the serum creatine kinase （CK） level of amyotrophic lateral sclerosis （ALS） patients and to examine the relationship between CK level and age, sex, duration of disease, clinical severity and clinical type of ALS. Methods The serum CK level of forty cases with definite diagnosis of ALS was evaluated before surgical procedure. Patients were divided into groups： clinical severity （mild, moderate, severe and terminal disease groups）, limb onset and bulbar onset groups, shorter （up to 12 months） and longer （over 12 months） duration of ALS groups, older （over 60 years old） and younger （up to 60 years old） groups. Results CK was elevated in 36%（15 cases） of the ALS patients and the average serum CK level was 88 U/L （25-562 U/L）. There were no significant differences in the serum CK levels between the groups of the ALS patients based on age （P = 0.85）, sex （P = 0.12）, duration of disease （P = 0.11） and clinical severity （P = 0.58）. The CK level was significantly higher in the serum of patients with a limb onset than in patients with a bulbar onset of ALS[ （206.13±29.56）U/L vs. （109.54±23.40）U/L, P = 0.02]. Conclusion Our study has confirmed that the serum CK activity was increased in the ALS patients. CK activity is dependent on a limb onset or a bulbar onset of ALS, but not on the duration of disease severity.