Pajoum Abdolkarim, Fahim Farshid, Akhlaghdoust Meisam, Zamani Nasim, Amirfirooz Zeinab, Dehdehasti Mahnaz
Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
Emerg (Tehran). 2018;6(1):e56. Epub 2018 Sep 26.
Some studies have reported creatinine phosphokinase (CPK) as a new emerging way in predicting the outcomes of poisoned patients. This study aimed to evaluate the association of serum CPK level in the first 24 hours with outcomes of poisoned patients.
This retrospective cross-sectional study was performed using the medical profiles of poisoned patients aged between 13 and 70 years old who were referred to the emergency department of a big referral medical toxicology center during 6 years and whose necessary data for this study was available.
318 patients with the mean age of 34.9±14.5 years were studied (77.1% male). The mean serum CPK level of patients was 4693.1 ± 10303.8 (35-89480) IU/L. There was no significant correlation between serum CPK level and cause of poisoning (r= 0.16; p=0.51), age (r = -0.021; p = 0.651), sex (r = 0.131; p = 0.281), seizure (r = -0.022; p = 0.193), level of consciences (r = -0.138; p = 0.167), and duration of hospital stay (r= 0.242, p = 0.437). The mean serum CPK level was significantly higher in ICU admitted (p<0.0001), AKI (p<0.0001), hyperkalemia (p<0.0001), hypophosphatemia (p=0.045), and hypocalcaemia (p=0.008) cases. The best cut off point of serum CPK level in predicting acute kidney injury (AKI) was estimated to be 10000 IU/L (sensitivity = 83.8% and specificity = 68.8%).
It seems that CPK could be considered as a candidate tool for screening the intoxicated patients in need for ICU admission and at risk for AKI.
一些研究报告称肌酸磷酸激酶（CPK）是预测中毒患者预后的一种新方法。本研究旨在评估中毒患者最初24小时内血清CPK水平与预后的相关性。
本回顾性横断面研究使用了6年间转诊至一家大型转诊医疗毒理学中心急诊科的13至70岁中毒患者的病历，且有本研究所需的必要数据。
共研究了318例患者，平均年龄为34.9±14.5岁（男性占77.1%）。患者的平均血清CPK水平为4693.1±10303.8（35 - 89480）IU/L。血清CPK水平与中毒原因（r = 0.16；p = 0.51）、年龄（r = -0.021；p = 0.651）、性别（r = 0.131；p = 0.281）、癫痫发作（r = -0.022；p = 0.193）、意识水平（r = -0.138；p = 0.167）及住院时间（r = 0.242，p = 0.437）之间无显著相关性。入住重症监护病房（ICU）（p < 0.0001）、急性肾损伤（AKI）（p < 0.0001）、高钾血症（p < 0.0001）、低磷血症（p = 0.045）和低钙血症（p = 0.008）患者的平均血清CPK水平显著更高。预测急性肾损伤（AKI）时血清CPK水平的最佳截断点估计为10000 IU/L（敏感性 = 83.8%，特异性 = 68.8%）。
似乎CPK可被视为筛选需要入住ICU及有AKI风险的中毒患者的候选工具。
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