血管迷走性晕厥儿童、青少年血清肌酸激酶及其同工酶水平变化  

Changes in creatine kinase and its isoenzymes in children and adolescents with vasovagal syncope

作　　者：张娟[1] 林萍[1] 邹润梅[1] 杨红[1] 刘平[1] 李芳[1] 许毅[1] 王成[1] Zhang Juan;Lin Ping;Zou Runmei;Yang Hong;Liu Ping;Li Fang;Xu Yi;Wang Cheng(Department of Pediatric Cardiovascular, Children＇s Medical Center, the Second Xiangya Hospital, Central South Universit;Institute of Pediatrics, Central South University, Changsha 410011, Chin)

机构地区：[1]中南大学湘雅二医院儿童医学中心儿童心血管专科中南大学儿科学研究所,长沙410011

出　　处：《中华实用儿科临床杂志》2018年第11期846-849,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：湖南省自然科学基金（2016JJ2167,2018JJ3730）;湖南省发展改革委员会课题（2015-83）

摘　　要：目的探讨血管迷走性晕厥（VVS）儿童、青少年血清肌酸激酶（CK）及其同工酶（CK-MB）水平的变化。方法收集2015年10月至2017年8月在中南大学湘雅二医院门诊或住院、以不明原因晕厥或晕厥先兆为主诉、经直立倾斜试验（HUTT）确诊为VVS的儿童、青少年150例（VVS组），其中男69例，女81例；年龄4～17岁[（11.21±2.40）岁]；选取性别、年龄匹配的健康儿童、青少年99例为健康对照组，其中男58例，女41例；年龄4～17岁[（10.78±2.26）岁]。比较2组儿童血清CK、CK-MB水平的差异，采用受试者工作特征（ROC）曲线分析CK、CK-MB对诊断VVS的预测价值。结果1．与健康对照组相比，VVS组CK降低[（93.77±33.01） U/L比（125.02±58.06） U/L]、CK-MB降低[（21.31±6.99） U/L比（26.93±8.78） U/L]，差异均有统计学意义（均P〈0.05）。以CK 89.22 U/L作为界值对诊断VVS的灵敏度为76.80%，特异度为54.70%；以CK-MB 23.93 U/L作为界值对诊断VVS的灵敏度为66.70%，特异度为71.30%。2.VVS组性别差异：女童较男童CK降低[（85.25±29.43） U/L比（103.77±34.36） U/L]，差异有统计学意义（P〈0.05），CK-MB未见性别差异。3.VVS 3种血流动力学类型之间CK、CK-MB比较差异均无统计学意义（均P〉0.05）。但3种血流动力学亚型CK均较健康对照组降低，差异有统计学意义（均P〈0.05）；血管抑制型和混合型CK-MB均较健康对照组降低，差异有统计学意义（均P〈0.05）。结论儿童、青少年VVS血清CK和CK-MB水平较健康儿童、青少年降低，CK、CK-MB可能参与儿童、青少年VVS的发病机制。ObjectiveTo investigate the changes in creatine kinase （CK） and its isoenzymes （CK-MB） in children and adolescents with vasovagal syncope（VVS）.MethodsThe VVS group included 150 patients with unexplained syncope or prodromata[69 males and 81 females, aged from 4 to 17 years old, with the average age （11.21±2.40） years old], who had been diagnosed as VVS by using head-up tilt table test（HUTT）in the Second Xiangya Hospital, Central South University from October 2015 to August 2017.The healthy control group included 99 healthy children[58 males and 41 females, aged from 4 to 17 years old, with the average age （10.78±2.26）years old]with gender and age-matched.The differences in serum CK and CK-MB levels between 2 groups were compared, and receiver operating characteristic （ROC） curve was used to explore the predictive value of CK and CK-MB for diagnosing VVS.Results（1）Compared with the healthy control group, both CK[（93.77±33.01）U/L vs.（125.02±58.06） U/L] and CK-MB[（21.31±6.99） U/L vs.（26.93±8.78） U/L] levels decreased in the VVS group, and there were statistically significant differences（all P〈0.05）. When the value of CK was 89.22 U/L, the sensitivity to diagnostic VVS was 76.80%, and the specificity was 54.70%; while the value of CK-MB was 23.93 U/L, the sensitivity to diagnostic VVS was 66.70%, and the specificity was 71.30%.（2）In VVS group, the CK levels of the females were significantly lower than those of the males [（85.25±29.43） U/L vs.（103.77±34.36） U/L], and there was a statistical difference（P〈0.05）; while there was no significant difference in CK-MB between the males and the females in VVS group.（3）There were no significant differences between 3 types of VVS （all P〉0.05）. Compared with the healthy control group, CK decreased in all the 3 types of VVS （all P〈0.05）, while CK-MB decreased only in the vasodepressor type and mixed type （all P〈0.05）.ConclusionsCompared with the healthy children and adolescents, t

关 键 词：血管迷走性晕厥 肌酸激酶 肌酸激酶同工酶 儿童 青少年 

分 类 号：R446.112[医药卫生—诊断学]