单纯血清肌酶升高患者肌活检病理分析

Muscle biopsy in patients with simple elevation of serum muscle enzyme

目的通过分析单纯血清肌酶升高患者的肌肉病理诊断,了解单纯血清肌酶升高患者的病因。方法采用归纳分析法分析了24例单纯血清肌酶升高患者的人口学资料、血清肌酶水平、肌电图及病理特点。结果男性16例,女性8例,年龄3岁～54岁,平均年龄（32.56±15.93）岁。血清CK波动于577.40～17720.00 U/L之间,平均（8081.83±6065.50）U/L,LDH波动于150.20～1643.80 U/L之间,平均（415.30±324.90）U/L。20例患者肌电图检查提示,15例为肌源性损害,3例正常,1例可疑肌源性损害,1例仅表现为运动单位时限偏短。肌肉病理提示2例为正常（8.33%）、5例（20.83%）为非特异性散在肌萎缩以及17例为肌病（70.83%）,肌病包括肌营养不良13例（54.17%）,炎性肌病组3例（12.50%）和Danon病1例（4.17%）。结论无症状性单纯血清肌酶升高患者的病因较多,肌肉酶组织化学和免疫组织化学可以协助多数患者的病因诊断。

Objective To investigate the cause of elevated serum muscle enzyme by analyzing the pathological diagnosis in patients with simple elevation of serum muscle enzyme. Methods The demographic data,serum muscle enzyme levels,electromyography,and pathological characteristics of 24 patients with simple elevation of serum muscle enzyme were subjected to inductive analysis.Results There were 16 males and 8 females,who were aged from 3 to 54 years,and the mean age of onset was（ 32. 56 ± 15. 93）years. Creatine kinase levels were 577. 40- 17720. 00 U / L（ mean value： 8081. 83 ± 6065. 50 U / L） and lactate dehydrogenase levels were 150. 20- 1643. 80 U / L（ mean value： 415. 30 ± 324. 90 U / L）. Electromyography of 20 patients showed that 15 had myogenic damage,3 were normal,one was suspected of myogenic damage,and one had shortened motor unit time. Muscle pathology revealed that 2 cases（ 8. 33%） were normal,5（ 20. 83%） had nonspecific scattered muscle atrophy,and 17（ 70. 83%） had myopathy,including 13 cases（ 54. 17%） of muscular dystrophy,3 cases（ 12. 50%） of inflammatory myopathy,and one case（ 4. 17%） of Danon disease. Conclusions There are many causes of asymptomatic elevation of muscle enzyme,and muscle enzyme histochemistry and immunohistochemistry are conducive to the diagnosis in most patients.