假肥大型肌营养不良患者血清酶学与肌电图改变的相关性研究

目的研究假肥大型肌营养不良（DMD）患者血清酶学、肌电图改变，进一步分析之间的相关性。方法选择DMD患者45例，平均年龄（7．14±2．92）岁，分别测定血清磷酸肌酸激酶（cK）、乳酸脱氢酶（LDH）、肌酸激酶同工酶（CK—Mb）、肌红蛋白（Mb）等。并进行肌电图检测。结果所有DMD患者血清酶学均增高，平均CK（13109．38±3023．99）U／L，LDH（1258．99±331．5）U／L，CK—Mb（494．22士121．75）U／L，Mb（1417．07±461．47）U／L。共检测肌肉169块，发现肌源性损害肌肉73块，其中1DO％股四头肌存在肌源性损害。33．3％（15／45）存在肱二头肌肌源性损害，26．7％（12／45）三角肌存在肌源性损害。股四头肌时限下降百分比平均为（42．31±8．74）％。CK与Mb、CK—Mb、LDH均呈正相关，差异有统计学意义（P〈0．01）。Mb与CK—Mb、LDH均呈正相关，差异有统计学意义（P〈0．01）、CK—Mb与LDH呈正相关，差异有统计学意义（P〈0．01）。股四头肌时限下降百分比与CK、Mb、CK—Mb呈正相关，差异有统计学意义（P〈0．05）。CK、CK—Mb、股四头肌时限下降百分比等与病程明显相关，差异有统计学意义（P〈0．05）。结论血清CK、Mb是早期诊断DMD的特异性指标。联合肌电图检查，可提高诊断的敏感性和特异性和评估病程的进展速度。

Correlation analysis of serum enzymes and electromyography in patients with Duchenne muscular dystrophy

Objective To explore serum enzymes and electromyography characteristics in patients with Duehenne muscular dystrophy （DMD）, and to analyze the correlation among them. Methods Ser- um CK, LDH, CK--Mb and Mb were measured in 45 patients with DMD, whose mean age was （7.14± 2.92） years old, while electromyography （EMG） was recorded. Results The serum levels were markedly elevated in all of these enzymes. The mean value was as follows： CK： （13 109.38±3 023. 99）U/L, LDH： （1 258. 99±331.55）U/L, CK--Mb： （494. 22±121.75）U/L, Mb： （1 417.07±461.47） U/L. Needle elec- tromyography was done in 169 muscles, 73 of them were myopathic, including 45 medial vastus muscles （100% ,45/45）, 15 deltoid muscles （33.3~, 15/45） and 12 biceps braehii muscles （26.7%, 12/45）. The serum levels of Mb, CK-- Mb and LDH all correlated significantly with the levels of CK （P〈 0.01）. The serum levels of CK--Mb and LDH both correlated significantly with the level of Mb （P 0.01）. The percentage decrease of medial vastus muscle correlated significantly with the serum levels of CK, Mb, and CK--Mb. The percentage decrease of medial vastus muscle and the serum levels of CK, Mb, and CK--Mb were significantly correlated with the disease duration （P 〈 0. 01 or P 〈0.05）. Con- clusions Both serum CK and Mb were the specific markers for the diagnosis of DMD. The specificity and sensibility in diagnosis could be improved by combining serum enzymes with the results of EMG. These parameters are also valuable in predicting the progress of DMD.