The Clinical Analysis of Serum Creatine Kinase BB(CK-BB) in Acute Head Injury Patients

ABSTRACT

The extent of brain damage is known to be an essential predictive factor in the clinical course of patient with severe head injury. The purpose of the work was to study the usefulness of brain type creatine kinase(CK-BB) as a iochemical index of brain injury. We performed a Tri-check isoenzyme electrophoresis to determine the serum level of CK-BB in 123 patients with head injury. CK-BB isoenzyme was detected in the serum in 24 out of 123 patients with acute brain injury(19.5%). The peak of CK-BB activity ranged from 2 to 85IU/1 and mean value was 21.40+/-21.66IU/1. The activity was higher in patients with diffuse axonal injury, intracerebral hematoma and subdural hematoma than any other cases. The serum CK-BB isoenzyme was more frequently detected in low GCS score cases at admission and these patients had poor outcome than high GCS score cases. High CK-BB activity in serum was associated with poor prognosis, but a low CK-BB activity in serum was not necessarily a good prognostic sign. The presence of the serum CK-BB isoenzyme correlated with admission GCS score and with the ultimate outcome. We conclude that CK-BB level in serum is a reliable marker of cerebral parenchymal injury and may enhance the predictive value of the Glasgow coma scale score when used in conjunction with this indicant.