Changes in creatine kinase and its isoenzymes in children and adolescents with vasovagal syncope / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the changes in creatine kinase (CK) and its isoenzymes (CK-MB) in children and adolescents with vasovagal syncope (VVS).Methods The VVS group included 150 patients with unexplained syncope or prodromata[69 males and 81 females,aged from 4 to 17 years old,with the average age (11.21 ±2.40) years old],who had been diagnosed as VVS by using head-up tilt table test(HUTT) in the Second Xiangya Hospital,Central South University from October 2015 to August 2017.The healthy control group included 99 healthy children [58 males and 41 females,aged from 4 to 17 years old,with the average age (10.78 ± 2.26)years old] with gender and age-matched.The differences in serum CK and CK-MB levels between 2 groups were compared,and receiver operating characteristic (ROC) curve was used to explore the predictive value of CK and CK-MB for diagnosing VVS.Results (1) Compared with the healthy control group,both CK [(93.77 ± 33.01) U/L vs.(125.02 ± 58.06) U/L] and CK-MB [(21.31 ± 6.99) U/L vs.(26.93 ± 8.78) U/L] levels decreased in the VVS group,and there were statistically significant differences(all P ＜0.05).When the value of CK was 89.22 U/L,the sensitivity to diagnostic VVS was 76.80％,and the specificity was 54.70％;while the value of CK-MB was 23.93 U/L,the sensitivity to diagnostic VVS was 66.70％,and the specificity was 71.30％.(2) In VVS group,the CK levels of the females were significantly lower than those of the males [(85.25 ± 29.43) U/L vs.(103.77 ± 34.36) U/L],and there was a statistical difference (P ＜ 0.05);while there was no significant difference in CK-MB between the males and the females in VVS group.(3) There were no significant differences between 3 types of VVS (all P＞0.05).Compared with the healthy control group,CK decreased in all the 3 types of VVS (all P ＜ 0.05),while CK-MB decreased only in the vasodepressor type and mixed type (all P ＜ 0.05).Conclusions Compared with the healthy children and adolescents,the serum CK and CK-MB levels will decrease in children with VVS,which indicates that CK and CK-MB may be involved in the pathogenesis of VVS.