电烧伤患者血清肌酸磷酸激酶变化与电烧伤肌肉坏死感染的关系

目的：探讨血清肌酸磷酸激酶(craetine phos phokinase，CK)及其同工酶(CK—MM)的变化对电烧伤患者肌肉感染、坏死的诊断价值。方法：高压电击伤与电弧烧伤各40例，分为A、B两组，A组为手术证实有明显的肌肉坏死者，B组为手术证实无肌肉坏死者。分别监测患者伤后、术前及术后血清CK—MM的浓度，同期进行血、尿常规，肝、肾功能检查，并以30例正常人血清CK—MM值作为对照。结果：(1)A组伤后及扩创术后1天血清CK—MM的浓度显著升高，达正常对照组的5倍；术后3天降至正常，其变化与手术所见、外周血白细胞计数变化相一致；(2)B组植皮术前及术后CK-MM值轻度升高。结论：CK-MM可作为电击伤肌肉感染坏死的监测指标，具有较高的特异性和敏感性。

Change in serum creatine phosphokinase level in patients with electric burn and its relation with the infection and necrosis of the burn muscle

Objective: To evaluate the diagnostic value of the change in serum creatin phosphokinase (CK) and its isozymes (CK-MM) in muscular infection and necrosis of patients with electric burn. Method: Forty patients were divided into A and B groups according to the cause of burn. Those with electric injury were in group A and those with electric arc flame burn in group B. Serum CK-MM level was determined after injury, and before and after operations. Simultaneously, blood and urine routine, hepatic and renal function were examined and compared with those of 30 healthy persons. Result: Serum CK-MM level in group A increased significantly after injury and 1 day after wound debridement, up to 5 times of the healthy persons. Then lowered down to normal in 3 days after operation. Serum CK-MM level in group B increased slightly before and after operation. Conclusion: Serum CK-MM level can be used for monitoring muscle infection and necrosis in patients with electric burn. This method is highly specific and sensitive.