摘要
目的研究Duchenne型肌营养不良(DMD)患者血清酶学的相关性和差异性,进一步分析血清酶学与患者年龄、病程及肌肉脂肪浸润程度的相关程度,为诊断疾病、评估病情及康复治疗提供依据。方法纳入51例确诊为DMD的患者,年龄3~13(7.53±2.91)岁,病程1~11(4.31±2.64)a,发病年龄1~9(3.20±1.94)岁,分别测定患者CK、CK-MB、LDH、AST、ALT。根据临床表现对本组患者进行临床严重程度分级,对患者进行下肢肌肉磁共振检查,并进行评分。结果所有DMD患者血清酶学均有不同程度增高,CK(11008.73±5755.49)U/L,CK-MB(259.69±149.09)U/L,LDH(997.51±348.50)U/L,AST(166.73±68.39)U/L,ALT(286.42±134.31)U/L。其中CK与CK-MB呈正相关(r=0.485,P<0.01),与LDH呈正相关(r=0.623,P<0.01),与AST呈正相关(r=0.425,P<0.01),与ALT呈正相关(r=0.552,P<0.01),与年龄呈负相关(r=0.403,P<0.01),与病程呈负相关(r=0.423,P<0.01),与肌肉脂肪浸润等级分数呈负相关(r=0.409,P<0.01);CK-MB与LDH呈正相关(r=0.447,P<0.01),与AST无相关性(P>0.05),与ALT呈正相关(r=0.292,P<0.05),与年龄无相关性(P>0.05),与病程无相关性(P>0.05),与肌肉脂肪浸润等级分数无相关性(P>0.05);LDH与AST呈正相关(r=0.447,P<0.01),与ALT呈正相关(r=0.635,P<0.01),与年龄呈负相关(r=0.430,P<0.01),与病程呈负相关(r=0.292,P<0.05),与肌肉脂肪浸润等级分数呈负相关(r=0.414,P<0.01);AST与ALT呈正相关(r=0.558,P<0.01),与年龄呈正相关(r=0.397,P<0.01),与病程呈负相关(r=0.345,P<0.01),与肌肉脂肪浸润等级分数呈负相关(r=0.421,P<0.01);ALT与年龄呈负相关(r=0.566,P<0.01),与病程呈负相关(r=0.435,P<0.01),与肌肉脂肪浸润等级分数呈负相关(r=0.593,P<0.01);年龄与病程呈正相关(r=0.751,P<0.01),与肌肉脂肪浸润等级分数呈正相关(r=0.971,P<0.01);病程与肌肉脂肪浸润等级分数呈正相关(r=0.728,P<0.01)。结论肌酸激酶是早期发现DMD的敏感性指标,随疾病的进展而下降;随着患者年龄增长、病程越长,肌�
Objective To study the correlation and difference of serum enzymes in patients with Duchenne muscular dystrophy,and further analyze the correlation between serum enzymes and patientsage,course of disease and degree of muscle fat infiltration,so as to provide basis for the diagnosis,evaluation and rehabilitation of the disease.Methods Fifty one patients with DMD,aged 3-13 years(7.53±2.91),with a course of 1-11 years(4.31±2.64)and a onset age of 1-9 years(3.20±1.94),were selected.CK,CK-MB,LDH,AST and ALT were measured.According to the clinical manifestations,the clinical severity of patients in this group was graded,and the patients were examined by lower limb muscle magnetic resonance imaging,and scored.Results The levels of serum enzymes in all DMD patients were increased in varying degrees,with the average levels of CK(11008.73±5755.49)U/L,CK-MB(259.69±149.09)U/L,LDH(997.51±348.50)U/L,AST(166.73±68.39)U/L and ALT(286.42±134.31)U/L.CK was positively correlated with CK-MB(r=0.485,P<0.01),LDH(r=0.623,P<0.01),AST(r=0.425,P<0.01),ALT(r=0.552,P<0.01),age(r=0.403,P<0.01),course of disease(r=0.423,P<0.01),and grade score of muscle fat infiltration(r=0.409,P<0.01),CK-MB was positively correlated with LDH(r=0.447,P<0.01),no correlation with AST(P>0.05),positive correlation with ALT(r=0.292,P<0.05),no correlation with age(P>0.05),no correlation with course of disease(P>0.05),no correlation with muscle fat infiltration grade score(P>0.05);LDH was positively correlated with AST(r=0.447,P<0.01),and positive correlation with ALT(r=0.635,P<0.01),AST was positively correlated with ALT(r=0.558,P<0.01),positively correlated with age(r=0.397,P<0.01)and negatively correlated with course of disease(r=0.397,P<0.01),ALT was negatively correlated with age(r=0.566,P<0.01),course of disease(r=0.435,P<0.01)and grade of muscle fat infiltration(r=0.593,P<0.01);age was positively correlated with course of disease(r=0.751,P<0.01)and grade of muscle fat infiltration(r=0.971,P<0.01).The course of disease was positively correlated wit
作者
汪昌
周洁
石永光
沙从波
张杰
陈林
朱凌
徐银
张亮亮
喻绪恩
WANG Chang;ZHOU Jie;SHI Yongguang;SHA Congbo;ZHANG Jie;CHEN Lin;ZHU Ling;XU Yin;ZHANG Liangliang;YU Xuen(Affiliated Hospital of Institute of Neurology,Hefei 230038,China;Anhui University of Traditional Chinese Medicine,Hefei 230061,China)
出处
《中国实用神经疾病杂志》
2021年第11期954-960,共7页
Chinese Journal of Practical Nervous Diseases
基金
安徽中医药大学校级重点项目(编号:2020SJZD10)。
