肌酸激酶水平及其与肌萎缩侧索硬化症定量肌电图特征的关系。

Creatine kinase level and its relationship with quantitative electromyographic characteristics in amyotrophic lateral sclerosis.

机构信息

Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Neurosciences Center, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Clin Neurophysiol. 2018 May;129(5):926-930. doi: 10.1016/j.clinph.2018.01.071. Epub 2018 Feb 20.

DOI:10.1016/j.clinph.2018.01.071

PMID:29550653

Abstract

OBJECTIVE

To explore the relationship between serum creatine kinase (CK) level and electromyographic characteristics in patients with amyotrophic lateral sclerosis (ALS).

METHODS

Two hundred thirty-eight consecutive ALS patients were enrolled. All patients underwent electrophysiological study with a consistent approach. We calculated a compound muscle action potential (CMAP) sum score, and spontaneous potentials were graded from 0 to 4 depending on their density and distribution. We tested for any independent correlation of the CK levels with CMAP sum score, mean spontaneous potential (MSP) score, F wave persistence or conduction velocity.

RESULTS

The median serum CK level was 151 U/L. Log CK was independently correlated with MSP score (β = 0.07, 95% CI: 0.01-0.14, p = 0.032) and F persistence (β = -0.0013, 95% CI: -0.00251 to -0.0002, p = 0.02) but not with CMAP sum score or F wave conduction velocity. When stratified by sex, the correlation of log CK with MSP score and F persistence was significant in male but not female patients.

CONCLUSIONS

The results support that lower motor neuron loss and muscle denervation are associated with elevated CK levels of ALS patients.

SIGNIFICANCE

The severity of lower motor neuron loss and denervation might be involved in pathophysiological mechanisms of CK elevation in ALS patients.

摘要

目的

探讨肌酸激酶（CK）水平与肌萎缩侧索硬化症（ALS）患者肌电图特征之间的关系。

方法

纳入 238 例连续 ALS 患者。所有患者均采用一致的方法进行电生理研究。我们计算了复合肌肉动作电位（CMAP）总和评分，并根据其密度和分布将自发电位分级为 0 到 4 级。我们检测 CK 水平与 CMAP 总和评分、平均自发电位（MSP）评分、F 波持续时间或传导速度之间是否存在任何独立相关性。

结果

血清 CK 中位数为 151 U/L。Log CK 与 MSP 评分独立相关（β=0.07，95%CI：0.01-0.14，p=0.032）和 F 波持续时间（β=-0.0013，95%CI：-0.00251 至-0.0002，p=0.02），但与 CMAP 总和评分或 F 波传导速度无关。按性别分层后，Log CK 与 MSP 评分和 F 波持续时间的相关性在男性患者中显著，但在女性患者中不显著。