血清肌酸激酶和肌红蛋白在儿童急性良性肌炎中的变化特点及临床价值  

Changes and clinical significance of serum creatine kinase and myoglobin levels in benign acute childhood myositis

作　　者：苏梓涵 张乾忠[2] 姜红堃[2] SU Zihan;ZHANG Qianzhong;JIANG Hongkun(Department of Laboratory Medicine,National Clinical Research Center for Laboratory Medicine,The First Hospital of China Medical University,Shenyang 110001,China;Department of Pediatrics,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院检验科,国家医学检验临床医学研究中心,沈阳110001 [2]中国医科大学附属第一医院儿科,沈阳110001

出　　处：《中国医科大学学报》2024年第11期984-988,共5页Journal of China Medical University

基　　金：辽宁省教育厅基本科研项目(JYTMS20230073)。

摘　　要：目的探讨血清肌酸激酶(CK)和肌红蛋白(Mb)在儿童急性良性肌炎(BACM)中变化的特点及临床价值。方法收集我院2011年1月至2023年12月收治的78例BACM患儿的临床资料,回顾性分析其临床表现以及血清CK和Mb检测值的动态变化情况。结果78例患儿血清CK值为432~18440 U/L,平均2178.8 U/L。全部患儿CK检测值超过参考区间上限(310 U/L),其中检测值大于参考区间上限2倍72例(92.31%),>10倍15例(19.23%);>5000 U/L 5例(6.41%),>10000 U/L 1例(1.28%)。血清CK峰值多出现在发病第1~3天,之后逐渐降低,到发病第7天时约73%患儿的CK值已恢复至正常参考区间,与临床症状变化时间一致。检测血清Mb患儿66例,检测结果为13.3~2603.8 ng/mL,平均260.17 ng/mL。超过参考区间上限(116.3 ng/mL)者34例(51.52%),其中大于参考区间上限2倍20例(30.30%),>5倍7例(10.61%),>10倍3例(4.55%)。血清Mb峰值出现在发病第1~3天,之后迅速降低,至发病第5天时84.38%患儿恢复至正常参考区间。结论BACM患儿血清CK值明显升高,并与临床症状变化一致,可作为诊断BACM的重要依据之一。部分病例血清Mb值有不同程度的升高,对诊断BACM有较大的参考价值,应与血清CK同步检测。检测BACM患儿血清CK和Mb对了解病情、指导治疗有重要价值。Objective To explore the changes in serum creatine kinase(CK)and myoglobin(Mb)levels in benign acute childhood myositis(BACM)and their clinical significance.Methods The clinical data of 78 children with BACM treated in our hospital from January 2011 to December 2023 were collected,and the dynamic changes and clinical performance of serum CK and Mb levels were retrospectively analyzed.Results The CK levels of the 78 patients ranged from 432 U/L to 18440 U/L,with the mean level being 2178.8 U/L.The levels exceeded the upper reference limit(310 U/L)in all the patients.They were 2 and 10 times the upper reference limit in 72(92.31%)and 15(19.23%)patients,respectively,and were greater than 5000 U/L in 5(6.41%)patients and greater than 10000 U/L in 1 patient.The CK level usually peaked in the first 3 days of BACM onset before decreasing gradually.By the 7th day,CK levels in 73%of the cases decreased to the normal reference range,which was consistent with the change in clinical symptoms.Serum Mb samples were collected from 66 patients,and the levels ranged from 13.3 ng/mL to 2603.8 ng/mL,with the mean level being 260.17 ng/mL.In 34 patients(51.52%),the Mb levels were higher than the upper reference limit(116.3 ng/mL).Among these patients,20(30.30%),7(10.61%),and 3(4.55%)patients had Mb levels 2,5,and 10 times higher than the upper reference limit,respectively.Serum Mb levels peaked in the first 3 days of BACM onset and then decreased quickly.Furthermore,in 84.38%of the total cases,serum Mb levels decreased to the normal reference range by the 5th day of onset.Conclusion Serum CK levels in children with BACM are significantly increased,consistent with the changes in clinical symptoms,and therefore,could be regarded as an important basis for BACM diagnosis.Furthermore,serum Mb levels increase to varying extents,indicating a great reference value in BACM diagnosis,and should be tested simultaneously with serum CK.Testing for serum CK and Mb is of great significance for understanding the clinical conditions and guiding the

关 键 词：血清 肌酸激酶 肌红蛋白 儿童急性良性肌炎 

分 类 号：R725.9[医药卫生—儿科]