ICU重症患者血清CK、MYO升高的临床意义

目的了解ICU重症患者的血清肌酸磷酸激酶(CK)、肌红蛋白(MYO)升高的流行病学特征和临床意义。方法回顾性分析符合入选标准的3 282例ICU重症患者,分析患者不同性别、年龄、手术方式及不同疾病的CK、MYO升高的发生率。结果 CK、MYO升高的总发生率分别为55.7%和29.8%;在性别上,男性CK、MYO升高的发生率高于女性(P0.001);21岁以上年龄段中,CK升高的发生率高于20岁以下患者,41～60岁年龄段患者中,检测到的MYO水平高于20岁以下(P0.001);手术以心脏、颅脑、血管、肺部食道纵膈CK、MYO的升高发生率较高,心脏最高,分别为96.3%和64.9%;非手术患者CK依次以MODS、脑血管意外、脓毒症较高,MYO则为MODS、脓毒症、脑血管意外。结论 ICU重症患者肌肉损伤的发生率较高,应加强术后及危重症患者血清CK、MYO的监测。

Clinical significance of the elevation of serum CK and MYO in critically ill patients in ICU

Objective To investigate the epidemiological characteristics and clinical significance of the elevation of serum creatine phosphokinase （CK） and myoglobin （MYO） in critically ill patients in ICU. Methods Retrospective analysis of 3282 critically ill patients in ICU, we analyzed the incidence of elevation of serum CK and MYO in patients for different gender, age, operation site and different diseases. Results The total incidence of CK and MYO were 55.7% and 29.8% respectively. In gender, the incidence of CK and MYO elevation in men was higher than that in women （P<0.001）. The incidence of CK elevation was higher in the 21?year?old group than in the 20?year?old group, and higher in the myo 41?60?year?old group than in the 20?year?old group （P<0.05）. The increased incidence of CK and MYO in the operation of heart, brain, blood vessel, lung, esophagus and mediastinum was the higher （96.3% and 64.9%, respectively）, and that of the heart operation is the highest.The increased incidence of CK in MODS, cerebrovascular accident and sepsis were higher in non?surgical patients, while MODS, sepsis and cerebrovascular accident were higher in that of MYO. Conclusion The incidence of muscle injury is high in critically ill patients in ICU. The monitoring of serum CK and MYO should be strengthened for postoperative and critically ill patients.