免疫抑制法测定深圳地区13岁以下健康儿童CK-MB水平及分析

Detect the CK-MB Level with Immune Suppression Method in 5 Months～13 Healthy Children in Shenzhen Area and Explore the Reasons

目的了解免疫抑制法测定深圳地区5个月~13岁不同年龄健康儿童血清肌酸激酶MB同工酶(CK-MB)的含量水平,并分析其与方法学提供的参考区间的差异性,为本地区建立健康儿童CK-MB参考区间提供依据。方法收集2016年3~6月来医院保健科体检的健康儿童1 062例,依据年龄分为3组:5个月~3岁的学龄前组、4~6岁的幼儿组和7~13岁的小学组,并选择同期健康成人390例,采用免疫抑制法检测血清CK-MB含量,与方法学提供的参考区间比较,对含量超出范围的标本同时进行肌钙蛋白I(cTnI)、肌红蛋白(MYO)和心电图检测,并对结果进行统计分析。结果 1 062例健康儿童检出CK-MB含量异常率为66.20%(703/1 062),其中学龄前组、幼儿组和小学组CK-MB含量异常率分别为81.02%(239/295)、66.23%(251/379)和54.90%(213/388),各组CK-MB含量异常率的差异有统计学意义(χ~2=3.71~15.95,P<0.01~0.05),而390例健康成人血清CK-MB含量均<24 U/L;703例CK-MB含量异常标本中c Tn I含量均<0.034 ng/ml,有3例标本MYO结果稍有增高>61.5 ng/ml,但随后的心电图跟踪检查均未见异常;学龄前组、幼儿组及小学组儿童血清CK-MB含量(U/L)分别为41.52±19.38、35.09±14.37及28.15±7.86,不同年龄段儿童血清CK-MB含量的差异有统计学意义(t=2.60~4.13,P<0.05);健康儿童血清CK-MB含量为34.97±10.64 U/L,与健康成人血清CK-MB含量(16.05±7.13 U/L)的差异有统计学意义(t=13.93,P<0.01)。结论免疫抑制法检测深圳地区5个月~13岁健康儿童血清CK-MB含量异常率较高,临床上不能直接引用方法学提供的参考区间,应及时建立本地区健康儿童CK-MB免疫抑制法的正常参考区间,以便更好地为临床服务,降低误诊和不必要的确诊项目检查。

Objective To understand the immune suppression method test the levels of serum creatine kinase MB isoenzyme （CK-MB） in shenzhen area in 5 months～13 years aged healthy children, and provide the Results 1062 cases of healthy children CK - MB storage anomaly detection rate was 66.20% （ 703/1062 ） , including referencerange of analysis with the methodology, the difference of the CK-MB for the region to establish healthy children provides some references for the reference range. Methods Collected March to June 2016 medical care of hospital, 1062 cases of healthy children, according to the age is divided into five months to 3 years old preschool group,4～6 years old children and 7～13 years,primary competitions and other three groups, and selected the same healthy adults 390 cases,the immune suppression method is adopted to detect the contents of serum CK-MB, compared with methodology provides the reference range, content is beyond the scope of the specimen at the same time for troponin I （cTnl） , myoglobin （MYO） and electrocardiogram examination, and the results were analyzed. Results Preschool group,preschool and primary sections CK-MB content abnormal rate was 81.02 % （ 239 / 295 ） , 66.23 % （ 251/379 ） and 54.90 % （ 213/388） ,differences between groups of CK-MB content abnormal rate was statistically significant （X2= 3.71 ？15.95,P〈0.01 ～0.05 ）, and 390 cases of healthy adults in serum CK - MB content 〈 24 U/L; Specimens of 7 03 cases of abnormal CK - MB content of cTnl levels are 〈 0.034 ng/ml,3 cases of specimens MYO results increased slightly〉61.5 ng/ml, but then on the electrocardiogram trace examination,abnormality was not found; Preschool group,infants and children primary competitions in serum CK-MB content were 41.52 ± 19.38 U/L,35.09± 14.37 U/L and 28.15 ± 7.86 U/L,between different age children in the serum CK-MB content difference was statistically significant （t=2.596～ 2.596,P 〈0.05 ） ; Healthy children in serum CK - MB content was 34.97 ± 10.64 U/L,healthy adults in serum CK - MB content was 16.05 ± 7.13 U/L, between the two results was statistically significant difference （t= 13.927, P〈0.01） . Conclusion Detection of immune suppression in shenzhen area in 5 months ～13 years healthy children serum CK-MB in the abnormal rate is very high, no direct reference methodology to provide clinical reference range, therefore, regional health children CK-MB in time the normal reference range of immune suppression method should be established,in order to better serve the clinical, lest cause misdiagnosis and unnecessary confirmed project inspection.