免疫抑制法测定血清CK-MB致结果偏高的原因分析

目的：探讨免疫抑制法测定血清肌酸激酶同工酶（CK-MB）值高于总肌酸激酶（CK）的原因及解决方法。方法选择陕西省人民医院心内科已经确诊心肌梗死的住院病人68例，肿瘤内科恶性肿瘤病人32名，其中肝癌8例、肺癌6例、胃癌6例、神经母细胞瘤5例、乳腺癌4例、卵巢癌3例以及来源于消化内科肝硬化患者16例。另选取门诊体检中心健康体检者100例作为对照组。于罗氏 MODUALR 全自动生化分析仪上采用免疫抑制法测定 CK-MB，酶偶联速率法测定总CK活性。结果在68例心肌梗死病人血清中CK-MB单项升高21例，总 CK单项升高39例，二项指标同时升高30例；在32例恶性肿瘤患者中血清CK-MB单项升高11例，总活性升高3例，二项同时升高3例；16例肝硬化患者2例 CK-MB单项升高。结论采用免疫抑制法检测CK-MB作为心肌梗死诊断指标存在一定缺陷，且CK-MB结果升高与某些重度炎症、恶性肿瘤等有密切关系。

Analysis of the Reasons of the Higher Result of CK-MB with Immune Suppression Method for Detecting Serum CK-MB

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.