1型巨肌酸激酶血症误漏诊情况分析

目的调查研究1型巨肌酸激酶（macro—creatine kinase type 1，MCK—1）血症误漏诊现状。方法2002年4月-2010年5月我院常规检测生化全项或心肌酶谱的血清标本中筛查出经CK同工酶琼脂糖凝胶电泳分析确诊MCK-1血症35例，收集并整理其临床资料，对误漏诊情况进行分析。结果35例MCK-1血症中，共误漏诊31例（88．6％），其中漏诊18例（51．4％），误诊13例（37．2％）；误诊病例中以误诊为急性心肌梗死、肌肉疾病和2型巨肌酸激酶（MCK-2）血症较多见。结论MCK．1血症误漏诊情况临床上较常见，各科室医生尤其是急诊科和心内科医生应加强对本症的关注，以提高诊治水平。

Reserch and Analysis of Missed Diagnosis or Misdiagnosis of Macro Creatine Kinasemia Type 1

Objective To investigate the situation of missed and nfisdiagnosed of macro creatine kinasemia type I （MCK-I）. Methods The clinical data of 35 serum specimens sct＇eened from routine examinations and cardiac muscle zymogram examinations in our hospital were collected and reviewed, and the missed and misdiagnosed conditions were analyzed. Results There were 31 cases （88.6%） missed and misdiagnosed in 35 cases with MCK-1. The missed and misdiagnosed rate was 51.4% （18 cases） and 37.2% （13 cases） respectively. The MCI-1 was finally diagnosed by CK-MB agar gel electrophoresis which was frequently misdiagnosed as acute myocardial infarction, muscle diseases and MCK-2. Conclusion Missed diagnosis and misdiagno- sis of MCK-I are very common in clinical practice. Clinicians, especially emergency physicians and cardiologists, should pay more attention to MCK-I in order to reduce missed or misdiagnosed rates.