CK-MB与CK比率界值在鉴别心肌梗死与骨骼肌损伤中的应用  

Application of Ratio Cut Off of CK-MB/CK in Differential Diagnosis of Myocardial Infarction and Muscle Lesion

作　　者：焦连亭[1] 李冬[1] 

机构地区：[1]天津中医学院第一附属医院中心实验部,300193

出　　处：《天津医药》2001年第7期399-401,共3页Tianjin Medical Journal

摘　　要：目的:探讨CK-MB/CK比值鉴别诊断急性心肌梗死(简称心梗)和肌损伤的可行性。方法:采集心梗患者和肌损伤患者的肌酸激酶(CK)、肌酸激酶MB同工酶(CK-MB)资料,进行显著性分析,确定不同诊断界值后分别计算敏感性、特异性和诊断指数。在分析比较的基础上,最后确定鉴别诊断的比率界值。结果:心梗患者CK对数均值为617(162～3495)μ/L,肌损伤组为589(165～5452)μ/L,两组比较无显著性差异(t=1.74,P>0.05)。CK-MB心梗组对数均值高于肌损组,分别为68(9～530)μ/L和24(8～183)μ/L,t=5.83,P<0.01,但总体诊断指数小于150％。CK-MB/CK比值,心梗组均值亦高于肌损组,分别为(11.4±4.08)％和(4.47±2.07)％,t=11.17,P<0.01。将比率界值定为6％,其诊断指数可达176％,优于CK-MB峰值的诊断效率。结论:以CK-MB/CK比率界值作为鉴别诊断心梗和肌损伤的指标是可行的,同时提出了用CK、CK-MB诊断心梗的4条标准。To study the differential diagnostic feasibility of ratio cut off of CK-MB/CK for acute myocardial infarction and muscle lesion. Methods:The data of CK and CK-MB were collected from the patients with myocardial infarction (group I) and the patients with muscle lesion (group II) and statistically analyzed respectively,so as to calculate their sensitivity, sepcificity and diagnostic index. Results: About the logarithm mean value of CK, there was no significant differentce between thegroupl [ 617(162-3 495 )u/L] and the group II [ 589(165-5 432)u/L] (t = 1.74, P>0.05). The logarithm mean value of CK-MB in the group I [68(9~530)u/L] was significantly higher than that in group II [24(8~ 183)u/L] (t = 5.83, P < 0.01), but the general diagnostic index was less than 150 % . The CK-MB/CK ratio in the group I [(11.4 + 4.08)%] was significantly higher than that in group II [(4.47?.07)%] (t = 11.17, P<0.01) .When the cut off was determined as 6% , the diagnostic index could reach 176%. The diagnostic efficiency would be higher than that of CK-MB peak value. Four pieces of criterion were suggested for diagnosing myocardial infarction with CK and CK-MB. Conclusion: According to the ratio cut off of CK-MB/CK,it is feasible to differentiate myocardial infarction from muscle lesion.

关 键 词：心肌梗塞 肌酸激酶 肌酸激酶同工酶类 骨骼肌损伤 诊断 

分 类 号：R542.22[医药卫生—心血管疾病]