Clinical significance of creatine kinase and creatine kinase isoenzyme in patients with traumatic rupture in early stage / 中国综合临床

ABSTRACT

Objective To investigate creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) changes of patients with traumatic rupture in the early stage.Methods Eighty-six patients with traumatic rupture who were treated in the Fourth Hospital Affiliated to China Medical University were enrolled to rupture group(rupture.group) and 40 cases of patients with abdominal trauma but non-rupture were admitted to abdominal trauma group.Another 40 healthy volunteers were enrolled to healthy control group.The myocardial enzymes were detected at before operation (T0),2 h after operation(T1),12 h after operation(T2),24 h after operation (T3),3 d after operation(T4) and 7 d after operation(T5).Results The contents of CK and CK-MB in rupture group,abdominal trauma group and control group were (573.4 ± 168.6) U/L and (30.4 ± 15.3) U/L,(59.3 ± 37.5) U/L and (7.6 ± 4.8) U/L,(30.7 ± 16.2) U/L and (5.6 ± 1.4) U/L respectively.There was significant difference among three group (F =295.696,90.109 ; P ＜ 0.001).SNK test showed that the contents of CK and CK-MB in rupture group were higher than that in abdominal trauma group or control group(P ＜ 0.05),and there was no significant difference between abdominal trauma group and control group(P ＞0.05).The contents of CK and CK-MB levels in rupture group at T1,T2,T3,T4 and T5 were (668.2 ±215.4),(589.3 ± 187.6),(551.2 ±202.8),(214.9 ± 194.5),(134.2 ± 118.3) U/L and (36.8 ± 17.5),(29.3 ± 16.4),(27.9 ± 17.3),(15.6 ± 9.7),(10.1 ± 4.4) U/L respectively,which were all higher than that in abdominal trauma group (CK(67.5 ±41.8),(43.5 ±24.7),(34.2 ± 17.6),(33.4 ±16.5),(32.2 ±17.1) U/L;CK-MB(8.1 ±5.2),(7.5 ±4.3),(7.1 ±3.9),(6.7 ±2.5),(6.1 ± 1.9)U/L),and the differences were statistically significant(P ＜ 0.05).At T0,T1 and T3 time point,the content of CK-MB of patients with Ⅲ and Ⅳ stage in rupture group were (37.9 ± 15.2),(42.8 ± 16.9),(33.2 ± 17.2),(29.7 ± 16.6) U/L respectively,higher than that in patients with Ⅰ and Ⅱ stage ((26.5 ± 17.3),(31.2 ±18.2),(25.3±15.7),(23.2±18.4) U/L;P ＜0.05).Conclusion The CK and CK-MB levels of patients with traumatic rupture appear elevated at early stage.Meanwhile,the changes of CK-MB are positively correlated with the rupture injury classification,which indicated that myocardial injury may appear in early stage of patients with traumatic rupture.It should be concerned myocardial enzymes changes in patients as early as possible.