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目的观察Duchenne肌营养不良(Duchenne Muscular Dystrophy,DMD)患儿血清心肌酶谱是否随病程进展变化及其规律。方法回顾性分析1984—2011年299例来中国医科大学附属盛京医院发育儿科就诊的DMD患儿血清心肌酶谱水平,包括天冬氨酸转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和α-羟丁酸脱氢酶(α-HBDH)。依据发病特点将DMD患儿不同年龄段分为3组:<5岁组、5～<10岁组、≥10岁组。所有数据资料经方差齐性及正态分布检验,计量资料取对数后符合正态分布规律进行分析。结果 DMD患儿各年龄组心肌酶谱均显著升高,且<5岁组、5～<10岁组心肌酶谱升高最明显,≥10岁组心肌酶谱显著低于<5岁组、5～<10岁组。结论 DMD患儿血清心肌酶谱10岁升高最明显,之后随年龄增加呈下降趋势,这种变化规律可以反映肌纤维坏死速率和病程进展速度。

Investigating the changes of serum myocardial enzyme levels in children with Duchenne muscular dystrophy

??Abstract??Objectives??To observe whether serum myocardial enzyme level changes with clinical progression and age in patients with Duchenne Muscular Dystrophy ??DMD??. And the regularity in the changes. Methods??Retrospectively analyze the serum myocardial enzyme level ??include AST?? CK?? CK-MB?? LDH?? α-HBDH?? of 299 patients with DMD from Department of Developing Pediatric in Shengjing Hospital of China Medical University from 1984 to 2011. They were divided into three groups according to clinic characteristics?? ??1?? The age between 0 to < 5 years old was in group 1????2?? The age between 5 to < 10 years old was in group 2 ?? ??3?? Older than 10 years old was in group 3. Results??The serum myocardial enzyme level was high in all the patients of DMD. The highest was found in 2 and 3 groups. The serum myocardial enzyme level was lower in group 3 than that of 1 and 2 groups. Conclusions??The serum myocardial enzyme level reaches a peak before 10 years old and then reduces with increasing age in children with DMD. The characteristis of changes of serum myocardial enzyme level are suspected to reflect the rate of muscle decay.