中长跑运动员大强度训练后心肌功能改变及肌酸激酶的评估价值

目的：分析中长跑运动员有氧与无氧训练后出现的异常高肌酸激酶水平及对运动员心肌功能的影响。方法：于2003／03选取上海市及上海体育学院田径队中长跑组二级以上运动员为观察对象。随机分为有氧组（n=12）和无氧组（n=14）。根据个人运动专长，安排相应专项训练。12名进行有氧训练项目：先进行6000m跑耐力训练，间歇8min，进行8000m速度跑，再问歇6min后，冲刺2000m；14名进行无氧训练项目：进行6000m跑耐力训练，间歇8min，进行2000m速度跑，间歇4min，再进行两次600m跑，其问间歇2min，随后进行两次200m冲刺，成绩：男24s2～28s5，女28s7～31s6，其间间歇2min。分别在训练前及运动后即刻抽静脉血，检测肌酸激酶及其他心肌功能相关指标的改变。结果：26名运动员均完成全部训练，进入结果分析。①有氧组和无氧组运动员训练前，肌酸激酶基础值均处于较高水平[（367．75&;#177;312．53），（380．64&;#177;286．45）U／L]。②运动员训练后，所选8项指标乳酸、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、碱性磷酸酶活性及肌红蛋白、血红蛋白、血糖水平均呈升高趋势。③8项指标在运动后的升高幅度，无氧组均大于有氧组。㈤丽组运动员训练前后，乳酸、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、碱性磷酸酶活性及肌红蛋F]水平改变均呈显著差异。（勤训练监测过程中，有3名运动员肌酸激酶、肌酸激酶同工酶及肌红蛋白的运动前基础值及运动后升高值均呈高度异常。结论：①不同运动项目及训练方式对心肌功能相关指标的影响存在明显差异。②联合应用乳酸、肌酸激酶、肌酸激酶同工酶、活性肌红蛋白等检测，可以更有效地监控运动员心肌损伤。③对训练后出现异常高肌酸激酶水平的运动员应及时观察肌钙蛋白水平。     

血清心肌型肌酸激酶同工酶活性大于肌酸激酶的病例分析

目的 对血清心肌型肌酸激酶同工酶(CK-MB)活性大于肌酸激酶(CK)的病例进行分析。方法 选取2019年1月至2020年7月在西安市儿童医院收治的血清CK-MB活性大于CK的103例患儿进行回顾性分析,103例患儿按照年龄分为新生儿组23例、婴儿组38例、幼儿组24例、学龄前期组10例及学龄期组8例。分析103例患儿的年龄、性别、疾病谱,并比较各年龄组CK、CK-MB活性和CK-MB质量(CK-MB mass)的检测结果。结果 103例患儿中,男性49例(47.57%),女性54例(52.43%)。新生儿组CK、CK-MB活性及CK-MB mass的检测结果明显高于其他年龄组,差异有统计学意义(P<0.05)。103例患儿中呼吸系统疾病38例(36.89%),心血管系统疾病12例(11.65%),传染性疾病12例(11.65%),消化系统疾病11例(10.68%),血液肿瘤系统疾病10例(9.71%),神经系统疾病8例(7.77%),免疫系统疾病4例(3.88%),皮肤感染2例(1.94%),泌尿系统疾病2例(1.94%),原因不明4例(3.88%)。疾病谱前3位依次为先天性心...     

人心肌线粒体肌酸激酶的提纯及抗体制备

目的从人心肌中分离纯化肌小节型线粒体肌酸激酶(sMtCK),制备抗血清,从抗血清中制备对sMtCK有特异免疫反应的抗体,建立酶联免疫吸附试验(ELISA),测定血清sMtCK.方法采用超低温高速离心、硫酸铵分级提取、Sepharose CL6B层析等技术分离纯化sMtCK,免疫新西兰大白兔.应用自制抗sMtCK建立ELISA检测健康体检者、心肌炎及急性心肌梗死(AMI)患者血清sMtCK.结果经聚丙烯酰胺凝胶电泳(SDS-PAGE)和Western blot鉴定,纯化的sMtCK为单一蛋白质条带.制备的抗sMtCK多克隆抗体在琼脂糖免疫扩散实验和ELISA中的抗体效价分别为1∶32和1∶800.自制抗体建立的ELISA检测心肌炎和AMI患者的血清sMtCK阳性率分别为51.6%(16/31)和54.1%(20/37),与健康对照组相比差异有显著性(P<0.01).结论经离心、提取、纯化所得的sMtCK是免疫纯.建立的ELISA检测血清sMtCK有助于心肌炎和AMI的诊断.     

心肌肌钙蛋白I对小儿心肌炎的诊断价值及与肌酸激酶同功酶MB的对比研究

目的评估血清心肌肌钙蛋白 I( c Tn I)对小儿心肌炎的诊断价值 ,并与肌酸激酶同功酶 MB( CK-MB)进行对比研究。方法全自动生化分析仪对 c Tn I及 CK-MB进行定量检测。结果 1心肌炎组 c Tn I及 CK-MB均明显高于正常对照组 ( P<0 .0 0 1)。 c Tn I升高 2 2例 ,占 73% ,CK-MB升高 15例 ,占 5 0 % ,c Tn I与 CK-MB呈正相关。 2治疗 2周后 c Tn I与对照组比较有显著性差异 ( P<0 .0 0 1) ,CK-MB与对照组无显著性差异 ( P>0 .0 5 )。 3心肌炎组 13例 ST-T改变患儿测 c Tn I升高 12例 ( 92 % ) ,CK-MB升高 6例 ( 4 6 % )。结论 c Tn I及 CK-MB对小儿肌炎的诊断均较敏感。 c Tn I诊断时间窗宽于 CK-MB,特异性高于 CK-MB     

田径运动员肌酸激酶及其同工酶变化与运动能力的关系

运动训练中, Sauders曾指出,肌酸激酶 (CK)是肌肉应激最敏感的指标,可用于机能评定。然而 CK同工程酶受应激影响下变化特点是什么,报道尚少。本文旨在以田径运动员为研究对象,观察和比较不同负荷,调整恢复时总 CK、 CK－ MM、 CK－ MB的变化特点,及运动能力与酶活性变化的关系,为训练调控、运动能力评估提供最具实用价值的手段和理论依据。 1资料与方法 省田径运动员 46人,年龄 14～ 21岁 3男 14人,女 32人。实验前向教练员和运动员说明目的、要求及负荷方式、强度、量等事宜,取得他们的主动配合。不同负荷后取血：受试者…     

高敏心肌肌钙蛋白T对儿童常见病心肌损伤评估的价值

目的探讨高敏心肌肌钙蛋白T（hs-cTnT）及肌酸激酶MB型同工酶质量（CK-MBmass）在儿童常见疾病心肌损伤评估中的价值。方法分别将45例败血症、54例急性胃肠炎、53例急性上呼吸道感染、50例急性肺炎儿童作为败血症组、急性胃肠炎组、急性上呼吸道感染组及肺炎组,将同期61例健康儿童作为对照组。采集受试儿童静脉血,分离血清。采用Roche Cobas E411全自动电化学发光免疫分析仪及其配套hs-cTnT及CK-MBmass检测试剂盒检测hs-cTnT及CK-MBmass。hs-cTnT〉22.32pg/mL为阳性,CK-MBmass〉5.04ng/mL为阳性。结果急性胃肠炎组、急性上呼吸道感染组、肺炎组、对照组及败血症组儿童血清hs-cTnT、CK-MBmass浓度的差异有统计学意义（P〈0.05）。急性胃肠炎组、急性上呼吸道感染组、肺炎组和对照组儿童血清hs-cTnT、CK-MBmass浓度的差异无统计学意义（P〉0.05）。败血症组儿童血清hs-cTnT、CK-MBmass浓度均高于对照组、急性胃肠炎组、急性上呼吸道感染组、肺炎组（P〈0.05）。败血症组儿童hs-cTnT、CK-MBmass阳性率高于其他各组（P〈0.05）。败血症组儿童血清CK-MBmass阳性率高于hs-cTnT阳性率（P〈0.05）。结论 hs-cTnT评估儿童常见疾病心肌损伤的敏感性和特异性优于CK-MBmass,败血症儿童应及时监测血清hs-cTnT,以判断有无心肌损伤。     

运动机能评定中血红蛋白、肌酸激酶、尿素氮等指标的研究

目的：在对深圳市自行车队主要队员为期11个月的机能评定和训练调控中，观察和研究一些生理生化指标的变化特点。方法：测定18名自行车运动员队员的血红蛋白、睾酮、肌酸激酶、尿素氮、尿蛋白和尿隐血等指标，针对指标变化和训练要求进行营养调控。结果：服用运动营养品后男女自行车队员的血红蛋白及睾酮水平均有提高；尿素氮值超过正常值的上限(8.3mmol／L)的概率为7.6％；酸激酶超过4.17ukat／L概率为58.9％；训练后尿蛋白、尿隐血值达到3个“ ”的概率为81.5％．次日晨尿蛋白和尿隐血“ ”全消失占73.7％。结论：血红蛋白存在个体差异，其理想值应建立在个体差异上；测试中，肌酸激酶值较高时不一定是肌肉很疲劳，在自行车训练中补充电解质、低聚糖等渗能源饮料和训练后补充恢复冲剂对训练有很大促进作用。     

心肌肌钙蛋白Ⅰ对小儿心肌炎的诊断价值及与肌酸激酶同功酶MB的对比研究

目的评估血清心肌肌钙蛋白I(cTnI)对小儿心肌炎的诊断价值,并与肌酸激酶同功酶MB(CK-MB)进行对比研究.方法全自动生化分析仪对cTnI及CK-MB进行定量检测.结果①心肌炎组cTnI及CK-MB均明显高于正常对照组(P＜0.001).cTnI升高22例,占73%,CK-MB升高15例,占50%,cTnI与CK-MB呈正相关.②治疗2周后cTnI与对照组比较有显著性差异(P＜0.001),CK-MB与对照组无显著性差异(P＞0.05).③心肌炎组13例ST-T改变患儿测cTnI升高12例(92%),CK-MB升高6例(46%).结论 cTnI及CK-MB对小儿肌炎的诊断均较敏感.cTnI诊断时间窗宽于CK-MB,特异性高于CK-MB.     

血清心肌肌钙蛋白-I、肌酸激酶同工酶对新生儿缺氧缺血性脑病心肌损伤的诊断价值

目的 探讨血清心肌肌钙蛋白I（CTn-I）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）及CK-MB／CK对新生儿缺氧缺血性脑病（HIE）患儿心肌损伤的诊断价值。方法 对2001年8月至2003年12月78例HIE患儿与对照组同期入住新生儿病房26例无缺氧性脑痛的患儿于出生后18～24h取血，分别用快速固相免疫层析法、NAC-免疫抑制法、NAC法测定血清CTn-I、CK、CK-MB并计算CK-MB／CK值。结果 对照组、轻、中、重HIE四组患者间血清CTn-I、CK、CK-MB有显著性差异（P〈0．05）。其中3例重度HIE伴阵发性室性心动过速，CTn-I〉125ng／L；而CK-MB虽有升高，但无明显差异；CK-MB／CK值在各组中无明显差异。结论 重视对HIE患儿心脏功能的监测与治疗，对改善患儿的预后具有非常重要的意义，在评价HIE患儿心肌损伤时，CTn-I是比CK-MB及CK更敏感、更具有特异性的指标，所以CK-MB／CK不宜作为HIE患儿心肌损伤的生化指标。     

血清心肌肌钙蛋白-Ⅰ、肌酸激酶同工酶对新生儿缺氧缺血性脑病心肌损伤的诊断价值

目的探讨血清心肌肌钙蛋白Ⅰ(CTn-Ⅰ)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及CK-MB/CK对新生儿缺氧缺血性脑病(HIE)患儿心肌损伤的诊断价值.方法对2001年8月至2003年12月78例HIE患儿与对照组同期入住新生儿病房26例无缺氧性脑病的患儿于出生后18～24 h取血,分别用快速固相免疫层析法、NAC-免疫抑制法、NAC法测定血清CTn-Ⅰ、CK、CK-MB并计算CK-MB/CK值.结果对照组、轻、中、重HIE四组患者间血清CTn-Ⅰ、CK、CK-MB有显著性差异(P＜0.05),其中3例重度HIE伴阵发性室性心动过速,CTn-Ⅰ＞125 ng/L;而CK-MB虽有升高,但无明显差异;CK-MB/CK值在各组中无明显差异.结论重视对HIE患儿心脏功能的监测与治疗,对改善患儿的预后具有非常重要的意义,在评价HIE患儿心肌损伤时,CTn-Ⅰ是比CK-MB及CK更敏感、更具有特异性的指标,所以CK-MB/CK不宜作为HIE患儿心肌损伤的生化指标.     

The creatine kinase system in the serum of runners following a doubling of training mileage

Summary This study examined the response of the serum creatine kinase (CK) isoenzyme/isoform system following the stress of successive weeks of increased training. Four highly-trained male long-distance runners doubled their training mileage [45.0 (SD 3.5) to 81.2 (4.7) miles] for 3 weeks. Venous blood samples were obtained prior to the start of the increased training period and at the end of each week, days 7, 14, and 21, 12 h after a training run. All runners experienced a significant increase in training perception difficulty, which correlated with the significant increase in training mileage. While total CK activities did not become significantly elevated until day 14, the tissue isoform CK-MM3, as well as the ratio of CK-MM3 to MM1 (final CK-MM degradation isoform) became significantly elevated at day 7 and remained elevated throughout day 21. These findings demonstrate that an increase in training mileage caused a significant and continuous release of tissue CK activity from skeletal muscle into the circulation.     

Changes in creatine kinase activity in the course of acute myocardial infarction

Peak activity of creatine kinase (CK; EC 2.7.3.2) and its decline were determined in 380 patients with acute myocardial infarction (AMI) whose CK values had peaked after admission to the hospital. During hospitalization, 26 patients either died (14 patients) or experienced nonfatal re-infarction (12 patients). In 22 of these 26 patients CK activity decreased by less than 50% within 48 h after the peak value was measured. In all patients who did not die or develop re-infarction, CK activity decreased by greater than 50% during the 48 h after the peak. Evidently the rate of decline of CK (i.e., whether more than or less than 50%) from its peak value during the 48 h after AMI may be helpful in assessing which patients are at high risk for developing re-infarction or dying.     

Myoglobin concentration,creatine kinase,and creatine kinase sub-unit B activity in serum after myocardial ischaemia

The myoglobin concentration. creatine kinase and creatine kinase sub-unit B activity were estimated in fourteen patients with ischaetmic heart disease before and after exercise induced angina pectoris. No changes in these parameters were found.     

Myoglobin concentration, creatine kinase, and creatine kinase sub-unit B activity in serum after myocardial ischaemia

The myoglobin concentration, creatine kinase and creatine kinase sub-unit B activity were estimated in fourteen patients with ischaemic heart disease before and after exercise induced angina pectoris. No changes in these parameters were found.     

Use of creatine kinase MB isoenzyme for diagnosing myocardial infarction when total creatine kinase activity is high

The usefulness of measuring creatine kinase MB isoenzyme for diagnosing myocardial infarction when activities of total creatine kinase are very high is unclear. We conducted a retrospective study in an urban hospital that serves a largely indigent population. We concentrated on 146 patients whose creatine kinase activity was greater than 1000 U/L (upper limit of normal: 165 U/L for women and 225 U/L for men), with MB isoenzyme greater than 10 U/L and less than 5% of total creatine kinase. The positive predictive value of MB isoenzyme (isoimmune method) values greater than 10 U/L was between 11.6% and 56.8% when the value for total creatine kinase exceeded 1000 U/L. Using different values (MB greater than 4% of total creatine kinase) as positive for myocardial infarction would have resulted in far fewer false-positives, but 10 cases of myocardial infarction would have been missed. The most appropriate cutoff value for MB isoenzyme in this population (total creatine kinase greater than 1000 U/L) was found to be greater than 2% of total creatine kinase.     

Changes in serum creatine kinase isoenzyme activities after surgical procedures and cardioversion

Serum activities of creatine kinase (CK) and its isoenzymes were monitored before and 16 to 20 hours after a variety of surgical procedures and cardioversion. Changes in total CK and CK MM activities in the surgical patients were consistent with the extent of trauma; changes in these activities in the cardioversion patients were more variable, ranging from -2 to 1829 U/l, and were unrelated to the applied electrical force. CK MB activity was unchanged after cystoscopy but rose moderately in 60% of patients after cholecystectomy, in 43% of patients requiring only implantation of a new pacemaker box, and in 87% of patients after implantation of an entire pacemaker system. No increase exceeded 6U/l. Fifty per cent of patients requiring cardioversion showed rises; the maximum value was 40.9 U/l.     

高温高湿环境下接受强度训练机体补充水分前后血液流变学与凝血功能的变化

目的:观察海军陆战队员在高温高湿环境下强训时,保障供水和不保障供水情况下血液流变学和凝血系统的变化。方法:强训于2005-08进行,选择海军陆战队员121名,随机抽取64名为强训组,57名为陆勤人员作为对照组。强训组队员在39～41℃,六级大风环境中,负重30kg训练12h,前6h不供任何水分,后6h随时供给水分。对照组和强训组强训6,12h时分别取血测定血液流变学(14项)和凝血系统(6项)相关指标。结果:121名全部进入结果分析。①血液流变学指标:强训组不补充任何水分时14项指标均高于对照组(P<0.05,0.01),供给水分后各项指标均显著下降,仅全血低、中切还原黏度仍高于对照组外[(18.7±2.1),(20.4±4.2)mPa·s;(9.1±1.4),(9.9±1.7)mPa·s,P<0.05],其余各项与对照组比较差异不显著(P>0.05)。②凝血系统各指标:强训组不补充任何水分时凝血酶原时间、部分凝血活酶时间显著低于对照组[(10.4±0.2),(11.6±0.3)s;(24.7±1.2),(28.4±1.4)s,P<0.01];纤维蛋白原、D-二聚体、纤维蛋白降解产物、血小板显著高于对照组[(3.7±0.3),(2.9±0.4)g/L;(319.8±15.3),(241.5±13.7)mg/L;(7.5±0.5),(5.9±1.2)mg/L;(266.3±15.4),(174.5±22.0)×109L-1;P<0.01]。供给水分后各项指标有所恢复,但与对照组比较仍有显著差异(P<0.05)。结论:高温高湿环境下强训队员不补充水分时有不同程度的高凝、高黏状态,保障供水,保持人体血容量正常,可使血液流变学指标基本处于正常状态,发生高黏的可能性也减小。     

高温高湿环境下接受强度训练机体补充水分前后血液流变学与凝血功能的变化

目的：观察海军陆战队员在高温高湿环境下强训时，保障供水和不保障供水情况下血液流变学和凝血系统的变化。方法：强训于2005-08进行，选择海军陆战队员121名，随机抽取64名为强训组，57名为陆勤人员作为对照组。强训组队员在39-41℃，六级大风环境中，负重30kg训练12h，前6h不供任何水分，后6h随时供给水分。对照组和强训组强训6，12h时分别取血测定血液流变学（14项）和凝血系统（6项）相关指标。结果：121名全部进入结果分析。①血液流变学指标：强训组不补充任何水分时14项指标均高于对照组（P〈0．05，0．01），供给水分后各项指标均显著下降，仅全血低、中切还原黏度仍高于对照组外[（18．7&;#177;2．1），（20．4&;#177;4．2）mPa&;#183;s；（9．1&;#177;1．4），（9．9&;#177;1．7）mPa&;#183;s，P〈0．05]，其余各项与对照组比较差异不显著（P〉0．05）。②凝血系统各指标：强训组不补充任何水分时凝血酶原时间、部分凝血活酶时间显著低于对照组[（10．4&;#177;0．2），（11．6&;#177;0．3）s；（24．7&;#177;1．2），（28．4&;#177;1．4）s，P〈0．01]；纤维蛋白原、D-二聚体、纤维蛋白降解产物、血小板显著高于对照组[（3．7&;#177;0．3），（2．9&;#177;0．4）g／L；（319．8&;#177;15．3），（241．5&;#177;13．7）mg／L；（7．5&;#177;0．5），（5．9&;#177;1.2）mg／L；（266．3&;#177;15．4），（174．5&;#177;22．0）&;#215;10^9L^-1。；P〈0．01]。供给水分后各项指标有所恢复，但与对照组比较仍有显著差异（P〈0．05）。结论：高温高湿环境下强训队员不补充水分时有不同程度的高凝、高黏状态，保障供水，保持人体血容量正常，可使血液流变学指标基本处于正常状态，发生高黏的可能性也减小。     

Isoforms of creatine kinase isoenzymes in serum in acute myocardial infarction after intracoronary thrombolysis

Kinetics of the catalytic activities of creatine kinase (CK;EC 2.7.3.2) for three CK-3 and two CK-2 isoforms in serum were studied in 20 patients with myocardial infarction randomly assigned to receive either intracoronary urokinase (group A) or conventional therapy (group B). The temporal characteristics of isoform changes described were (a) time at which the isoform activities are significantly greater than initial values, (b) maximal rate (Ka) at which isoforms are released into blood, (c) time lag from onset of pain until maximum activity value, (d) peak value of each serum isoform, and (e) rate (Kd) at which each isoform is cleared from serum. Thrombolytic treatment induced earlier peak times in group A: for CK-3(3), 7.4 vs 20.0 h; for CK-3(2), 11.6 vs 24.8; for CK-3(1), 18.6 vs 34.3; for CK-2(2), 9.1 vs 17.8; and for CK-2(1), 11.8 vs 26.8 (numbers given are medians; for all isoforms, P less than 0.05). Ka values were at least twofold greater and the first increase was significantly earlier in the urokinase group. Consequently, the ratio for CK-3(3) to CK-3(1) activities peaked significantly earlier in group A. Isoform peak activities and Kd were not significantly different between the two groups.