血清肌红蛋白与肌酸激酶水平对癫痫与晕厥的鉴别诊断价值  

Value of serum myoglobin and creatine kinase levels in the differential diagnosis of epilepsy and syncope

作　　者：姜明[1] 闫欣[1] 闫立荣[1] 胡洪涛[1] JIANG Ming YAN Xin YAN Lirong HU Hongtao(Department of Neurology, Beijing Jishuitan Hospital, Beijing 100096, China)

机构地区：[1]北京积水潭医院神经内科,北京100096

出　　处：《临床急诊杂志》2017年第9期700-702,共3页Journal of Clinical Emergency

摘　　要：目的:探讨血清肌红蛋白(Mb)及肌酸激酶(CK)水平对癫痫与晕厥的鉴别诊断价值。方法:回顾性分析2012-11-2017-05在我院神经科急诊就诊的癫痫或晕厥的患者,共163例,其中强直阵挛性癫痫患者80例,晕厥患者83例,发病12h内抽静脉血,用化学发光法测定血清Mb水平,用速率法测定血清CK水平。结果:癫痫组患者的血清Mb水平[111.65(65.88~193.80)ng/ml]显著高于晕厥组[26.40(18.80~45.30)ng/ml](P<0.01);癫痫组患者的血清CK水平[122.00(77.50~193.50)IU/L]显著高于晕厥组[79.00(59.00~110.00)IU/L](P<0.01)。癫痫组患者血清Mb水平升高的比例(75.00%)显著高于晕厥组(8.43%)(P<0.01);癫痫组患者血清CK水平升高的比例(30.00%)显著高于晕厥组(7.23%)(P<0.01)。对于一过性意识障碍,考虑诊断为癫痫或晕厥的患者,血清Mb水平升高对于癫痫诊断的敏感性为75.00%,特异性为91.57%,血清CK水平升高对于癫痫诊断的敏感性为30.00%,特异性为92.77%。结论:血清Mb水平对癫痫(强直阵挛性)与晕厥的鉴别有一定的临床指导价值,血清CK水平对癫痫与晕厥鉴别的敏感性偏低。Objective：To investigate the value of serum myoglobin （Mb） and creatine kinase （CK） levels in the differential diagnosis of epilepsy and syncope. Method：A total of 163 patients with generalized tonic clonic seizure （80 patients） and syncope （83 patients） who visited the neurology emergency department of our hospital from November 2012 to May 2017 were enrolled into this study. Venous blood was collected within 12 hours of onset to measure the serum Mb level by Chemiluminescence method and the serum CK level by rate method. Result： The serum Mb level of the epilepsy group [111.65（65.88-193.80） ng/ml] was significantly higher than that of the syn- cope group [26.40（18.80-45.30） ng/ml]（P〈：0.01） ;The serum CK level of the epilepsy group [122. 00（77. 50 -193.50） IU/L] was significantly higher than that of the syncope group [79.00（59.00-110.00） IU/L]（P〈0. 01）. The proportion of elevated serum Mb level in epilepsy group （75.00%） was significantly higher than that in syncope group （8.43 % ）（P〈0.01） ;The proportion of elevated serum CK level in epilepsy group （30.00 % ） was significantly higher than that in syncope group （7.23 %）（P〈0.01）. For patients with transient cognitive impairment who were diagnosed with epilepsy or syncope, elevated serum Mb level had a sensitivity of 75 % and a specificity of 91.57% for diagnosis of epilepsy,while elevated serum CK level with a sensitivity of 30% and a specificity of 92.77 %. Conclusion.. Serum Mb level has certain clinical value for the differentiation of generalized tonic clonic seizure and syncope. Serum CK level is less sensitive to differentiate epilepsy from syncope.

关 键 词：肌红蛋白 肌酸激酶 癫痫 晕厥 

分 类 号：R742.1[医药卫生—神经病学与精神病学]