-
-
表 1 病例重要检查结果
病例 诊断 CK(U/L) CK-MB (U/L) 血钾(mmol/L) 特殊检查 病例1 原发性醛固酮增多症 573 928 2.71 肾上腺CT: 左侧肾上腺外侧支结节灶;肿瘤标志物:阴性 病例2 结缔组织病 1 063 2 024 3.47 左上肢肌电图:可疑肌源性损害,左上肢三角肌、肱二头肌电位异常 病例3 低促性腺激素型性腺功能减退症 88 154 2.42 无 病例4 心肌炎 370 645 3.85 肿瘤标志物:NSE为19.38 ng/mL 注:参考值CK 0~200 U/L(女),50~310 U/L(男);CK-MB 0~24 U/L(男/女);血钾3.50~5.50 mmol/L(男/女)。 表 2 热失活法测定CK、CK-MB活性(U/L)
组别 常规测定 热失活后测定 CK CK-MB CK CK-MB 正常对照者 58 9 57 2 心肌梗死患者 5 270 364 4 850 167 病例1 573 928 560 906 病例2 1 063 2 024 1 016 1 839 病例3 88 154 28 47 病例4 370 645 301 499 注:参考值CK 0~200 U/L(女),50~310 U/L(男);CK-MB 0~24 U/L。 表 3 倍比稀释后测定CK、CK-MB活性(U/L)
稀释倍数 病例1 病例2 CK CK-MB CK CK-MB 常规测定 573 928 1 063 2 024 1∶10稀释 54 91 82 147 1∶100稀释 7 10 9 16 注:参考值CK 0~200 U/L(女),50~310 U/L(男);CK-MB 0~24 U/L。 表 4 PEG沉淀后测定CK、CK-MB活性(U/L)
病例 常规测定 PEG沉淀后测定 CK CK-MB CK CK-MB 病例3 88 154 9 11 病例4 370 645 161 262 注:参考值CK 0~200 U/L(女),50~310 U/L(男);CK-MB 0~24 U/L。 -
[1] ROFFI M, PATRONO C, COLLET J P, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2016, 37(3): 267-315. doi: 10.1093/eurheartj/ehv320 [2] BOJINCA M, BOJINCA V C, BALANESCU A R, et al. Macro creatine kinase (macro CK) in clinical practice[J]. Rev Chim, 2018, 69(8): 2107-2109. doi: 10.37358/RC.18.8.6483 [3] 李朝辉, 廖梅嫣, 胡雅, 等. 严重脓毒症和脓毒症休克患者cTnT、CK-MB水平变化及意义[J]. 中国现代药物应用, 2020, 14(17): 89-91. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY202017038.htm [4] 王霞. 肌酸激酶同工酶MB活性大于总肌酸激酶活性的原因分析[J]. 国际检验医学杂志, 2016(13): 1860-1862. doi: 10.3969/j.issn.1673-4130.2016.13.049 [5] ABDUL R, OMAR M, NAYAK S, et al. A case of spuriously high CK-MB: Contemplate beyond cardiac[J]. Med J Aust, 2017. DOI: 10.21767/AMJ.2017.3122 [6] OTA T, HASEGAWA Y, MURATA E, et al. False-positive elevation of CK-MB levels with chest pain in lung adenocarcinoma[J]. Case Rep Oncol, 2020, 13(1): 100-104. doi: 10.1159/000505724 [7] ALJUANI F, TOURNADRE A, CECCHETTI S, et al. Macro-creatine kinase: A neglected cause of elevated creatine kinase[J]. Intern Med J, 2015, 45(4): 457-459. doi: 10.1111/imj.12710 [8] MOGHADAM-KIA S, ODDIS C V, AGGARWAL R. Approach to asymptomatic creatine kinase elevation[J]. Cleve Clin J Med, 2016, 83(1): 37-42. doi: 10.3949/ccjm.83a.14120 [9] WADA Y, TANIGAWA J, ISHIZAKA N. Macro-CK and CK-BB contributing to sham CK-MB elevation[J]. Intern Med, 2017, 56(11): 1449-1450. doi: 10.2169/internalmedicine.56.8329 [10] CHANG C C, LIOU C B, SU M J, et al. Creatine kinase (CK)-MB-to-total-CK ratio: a laboratory indicator for primary cancer screening[J]. Asian Pac J Cancer Prev, 2015, 16(15): 6599-6603. doi: 10.7314/APJCP.2015.16.15.6599 [11] KAPLAN A, ORHAN N, ILHAN E. False positive troponin levels due to heterophil antibodies in a pregnant woman[J]. Turk J Emerg Med, 2016, 15(1): 47-50. http://core.ac.uk/download/pdf/82081685.pdf [12] MAIR J, LINDAHL B, MVLLER C, et al. What to do when you question cardiac troponin values[J]. Eur Heart J Acute Cardiovasc Care, 2018, 7(6): 577-586. doi: 10.1177/2048872617708973 [13] 鲁军, 程歆琦, 禹松林, 等. 异嗜性抗体干扰化学发光方法检测cTnI的处理和分析[J]. 现代检验医学杂志, 2018, 33(2): 101-104. doi: 10.3969/j.issn.1671-7414.2018.02.028 [14] 倪娟, 高洪柳, 王国洪, 等. 化学发光法检测促甲状腺激素结果假性增高1例[J]. 临床检验杂志, 2016, 34(9): 720. https://www.cnki.com.cn/Article/CJFDTOTAL-LCJY201609023.htm [15] FAVRESSE J, LARDINOIS B, NASSOGNE M C, et al. Anti-streptavidin antibodies mimicking heterophilic antibodies in thyroid function tests[J]. Clin Chem Lab Med, 2018, 56(7): e160-e163. doi: 10.1515/cclm-2017-1027 [16] LAUTENBACH N, MVNTENER M, ZANONI P, et al. Prevalence and causes of abnormal PSA recovery[J]. Clin Chem Lab Med, 2018, 56(2): 341-349. doi: 10.1515/cclm-2017-0246 [17] 黎宇. 溶血对CK-MB测定的影响分析[J]. 医药前沿, 2018, 8(11): 247. doi: 10.3969/j.issn.2095-1752.2018.11.211 -