异位妊娠中肌酸磷酸激酶的再探讨：其MB和MM同工酶组分的显著诊断价值
Creatine phosphokinase in ectopic pregnancy revisited: significant diagnostic value of its MB and MM isoenzyme fractions.
作者信息
Katsikis Ilias, Rousso David, Farmakiotis Dimitrios, Kourtis Anargyros, Diamanti-Kandarakis Evanthia, Zournatzi-Koiou Vassiliki, Panidis Dimitrios
机构信息
Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Am J Obstet Gynecol. 2006 Jan;194(1):86-91. doi: 10.1016/j.ajog.2005.06.047.
OBJECTIVE
Although evidence on elevated creatine phosphokinase (CPK) as a tool for the diagnosis of ectopic pregnancy (EP) is rather conflictive, no previous study on CPK isoenzyme levels and their relative ratio was found in the literature.
STUDY DESIGN
Forty women with EP, 20 with intrauterine (IU) abortive gestation, and 20 regular pregnant women (controls) were studied. Serum total CPK, CPK-MB, and CPK-MM levels were measured at the time of presentation and 24 hours after surgery. Relative operating characteristic (ROC) curves were plotted.
RESULTS
Women with EP had significantly higher CPK concentrations and a significantly decreased CPK-MB relative ratio (CPK-MB%), compared with both women with IU abortive pregnancy and controls. The ROC curves demonstrated a significant discriminatory ability of both increased total CPK and decreased CPK-MB% ratio for the diagnosis of EP.
CONCLUSION
Determination of CPK isoenzyme fractions can significantly enhance the diagnostic value of total maternal CPK in the prediction of ectopic pregnancy.
目的
尽管关于肌酸磷酸激酶（CPK）升高作为诊断异位妊娠（EP）的工具的证据相当矛盾，但在文献中未发现此前关于CPK同工酶水平及其相对比例的研究。
研究设计
对40例异位妊娠女性、20例宫内（IU）流产妊娠女性和20例正常孕妇（对照组）进行研究。在就诊时及手术后24小时测量血清总CPK、CPK-MB和CPK-MM水平。绘制相对操作特征（ROC）曲线。
结果
与宫内流产妊娠女性和对照组相比，异位妊娠女性的CPK浓度显著更高，CPK-MB相对比例（CPK-MB%）显著降低。ROC曲线显示，总CPK升高和CPK-MB%比例降低对异位妊娠的诊断均具有显著的鉴别能力。
结论
测定CPK同工酶组分可显著提高母体总CPK在预测异位妊娠中的诊断价值。
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