血清心肌型肌酸激酶同工酶活性大于肌酸激酶的病例分析

Case analysis of serum creatine kinase isoenzyme-MB activity greater than creatine kinase

目的对血清心肌型肌酸激酶同工酶(CK-MB)活性大于肌酸激酶(CK)的病例进行分析。方法选取2019年1月至2020年7月在西安市儿童医院收治的血清CK-MB活性大于CK的103例患儿进行回顾性分析,103例患儿按照年龄分为新生儿组23例、婴儿组38例、幼儿组24例、学龄前期组10例及学龄期组8例。分析103例患儿的年龄、性别、疾病谱,并比较各年龄组CK、CK-MB活性和CK-MB质量(CK-MB mass)的检测结果。结果103例患儿中,男性49例(47.57%),女性54例(52.43%)。新生儿组CK、CK-MB活性及CK-MB mass的检测结果明显高于其他年龄组,差异有统计学意义(P<0.05)。103例患儿中呼吸系统疾病38例(36.89%),心血管系统疾病12例(11.65%),传染性疾病12例(11.65%),消化系统疾病11例(10.68%),血液肿瘤系统疾病10例(9.71%),神经系统疾病8例(7.77%),免疫系统疾病4例(3.88%),皮肤感染2例(1.94%),泌尿系统疾病2例(1.94%),原因不明4例(3.88%)。疾病谱前3位依次为先天性心脏病合并下呼吸道感染、单纯下呼吸道感染及新生儿黄疸。103例患儿中,CK-MB mass正常的患儿80例。结论对于血清CK-MB活性大于CK的患儿,需要进行CK-MB mass检测,以防误诊。

Objective To analyze the case of serum creatine kinase isoenzyme-MB(CK-MB)activity greater than creatine kinase(CK).Methods From January 2019 to July 2020,103 cases of children with serum CK-MB activity greater than CK in Xi′an Children′s Hospital were selected for retrospective analysis,and the age,gender and disease spectrum of 103 cases were analyzed.The 103 children were divided into neonatal group(n=23),infant group(n=38),toddler group(n=24),pre-school group(n=10)and school-age group(n=8)according to age.The results of CK,CK-MB activity and CK-MB mass in different age groups were compared.Results 103 children included 49 males(47.57%)and 54 females(52.43%).The CK,CK-MB activity and CK-MB mass in neonatal group were significantly higher than those of other age groups,with statistical significance(P<0.05).Among the 103 children,there were 38 cases(36.89%)of respiratory system diseases,12 cases(11.65%)of cardiovascular system diseases,12 cases(11.65%)of infectious diseases,11 cases(10.68%)of digestive system diseases,10 cases(9.71%)of hematological tumor system diseases,8 cases(7.77%)of nervous system diseases.There were 4 cases(3.88%)of immune system diseases,2 cases(1.94%)of skin infection,2 cases(1.94%)of urinary system diseases and 4 cases(3.88%)of unknown causes.The three most common diseases were congenital heart disease with lower respiratory tract infection,lower respiratory tract infection alone and neonatal jaundice.Among 103 children,80 cases had normal CK-MB mass.Conclusion For children with serum CK-MB activity greater than CK,CK-MB mass should be applied to avoid misdiagnosis.