训练伤肌酸激酶异常增高的临床及实验室分析

Clinical and laboratory study of abnormal increase in creatine kinase caused by training injury

目的探讨和总结训练伤肌酸激酶(CK)明显异常的临床特征和实验室特点。方法回顾分析2008-08至2014-08在武警内蒙古总队医院就诊的112例训练伤伴CK异常增高战士的临床和实验室资料。结果 38例骨折和(或)软组织损伤病例的CK(3246±80.24)U/L比74例无明显外伤病例的CK(2465.03±65.32)U/L明显增高,差异有统计学意义(P<0.01);38例骨折和软组织损伤病例的CK-MB(14.10±2.64)ng/ml比74例无明显外伤病例的CK-MB(12.67±2.36)ng/ml略有增高,差异无统计学意义。38例肌痛伴晕厥和呼吸困难病例的CK(2743.52±64.14)U/L比36例单纯肌肉疼痛病例的CK(2171.66±66.72)U/L明显增高,差异有统计学意义(P<0.01);38例肌痛伴晕厥和呼吸困难病例的CK-MB(13.37±2.40)ng/ml比36例单纯肌肉疼痛病例的CK-MB(11.82±2.33)ng/ml略有增高,差异无统计学意义。结论进行CK-MB、Tn T、Mb、心电图、心脏彩超、X线检查用于判断是否骨折及心肌损害,可以明确诊断。重症训练伤多出现在新兵训练阶段,年龄小、身体瘦弱的战士是训练伤的高发人群。

Objective To study the clinical and laboratory characteristics of creatine kinase elevation due to training injury,thereby guiding the grass-roots medical work and training injury prevention. Methods Retrospective analysis was made of 112 patients with training injury hospitalized from August 2008 to August 2014 and analysis was made of their clinical and laboratory data,especially creatine kinase（ CK）. Results（ 3246 ± 80. 24） U / L in 38 patients with fracture and（ or） soft tissue injury were marked higher than in 74 subjects without evident trauma CK（ 2465. 03 ± 65. 32） U / L with statistical significant difference（ P〈0. 01）. CK-MB（ 14. 10 ± 2. 64） ng/ml in 38 patients with fracture and soft tissue injury was slightly higher than that in 74 patients without trauma（ 12. 67 ± 2. 36） ng/ml,without statistical significant difference（ P〉0. 05）. CK（ 2743. 52 ± 64. 14） U/L in 38 patients with myalgia accompanied by syncope and dyspnea was higher than that in 36 patients with simple muscle pain,CK（ 2171. 66 ± 66. 72） U / L,with statistical significant difference（ P〈0. 01）. CK-MB（ 13. 37 ± 2. 40） ng / ml in 38 patients with myalgia accompanied by syncope and dyspnea was slightly higher than that of 36 patients with simple muscle pain,CK-MB（ 11. 82 ± 2. 33） ng / ml,without statistical significant difference. Conclusions CK-MB,cardiac troponin,myoglobin,ECG,cardiac ultrasound,X-ray examination can be used for,diagnosis of fracture and myocardial damage. In the recruit training process,lower age,emaciated soldiers are prone to training injury.