1Clinical Centre, University Clinic for Toxicology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje; Republic of North Macedonia.
²Institute of Preclinical and Clinical Pharmacology with Toxicology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje; Republic of North Macedonia.
Georgian Med News. 2022 Mar(324):145-150.
The aim of this study was to determine the CK activity and its association with the length of hospital stay in acutely intoxicated patients with psychotropic and chemical substances. Rhabdomyolysis is defined as a creatine kinase (CK) > 250 U/L. We included adult patients ≥ 18 years of age, with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances in the first 48 hours. We excluded patients with rhabdomyolysis in muscle trauma as a result of a traumatic accident, myocardial infarction, cerebral vascular infarction, cerebral hemorrhage, and chronic hepatic and renal disease. In all patients with rhabdomyolysis, the mean CK on the first, third and fifth day was consequently 5715.9±16088.8 U/L with a maximum value of 129077 U/L vs. 5548.5±9851.5 U/L with a maximum value of 63947U/L vs. 2970.42±7161.68 U/L with a maximum value of 53672 U/L. The comparison for the whole sample in the three measurement times, for p <0.05, showed a significant difference (Friedman Test: N = 62; Chi-Square = 34.935; df = 2; p = 0.00001). For the whole sample of patients with rhabdomyolysis, as well as in the group of psychotropic intoxications, for p < 0.05, the level of CK on the first day was confirmed as an independent predictor that significantly affected the variability of the length of hospitalization by 5.2% (R2 = 0.052) vs. 20% (R2=0.200). In rhabdomyolysis, as a result of acute intoxication with psychotropic and chemical substances it is important to examine the creatine kinase. Creatine kinase levels were higher in rhabdomyolysis in acutely intoxicated patients with psychoactive compared to chemical substances. In the group intoxicated with psychoactive substances creatine kinase as an independent predictor significantly affected the length of hospitalization.
本研究旨在确定肌酸激酶(CK)活性及其与急性中毒患者住院时间的相关性。横纹肌溶解症定义为肌酸激酶(CK)>250 U/L。我们纳入了年龄≥18 岁,在最初 48 小时内急性中毒的精神和化学物质导致横纹肌溶解症的成年患者。我们排除了因创伤事故、心肌梗死、脑卒中等导致的肌肉创伤性横纹肌溶解症、脑出血和慢性肝肾功能不全患者。在所有横纹肌溶解症患者中,第 1、3 和 5 天的平均 CK 分别为 5715.9±16088.8 U/L,最大值为 129077 U/L,与 5548.5±9851.5 U/L,最大值为 63947U/L,与 2970.42±7161.68 U/L,最大值为 53672 U/L。在三次测量时间内,对所有样本进行比较,p<0.05,差异有统计学意义(弗里德曼检验:N=62;卡方=34.935;df=2;p=0.00001)。对于所有横纹肌溶解症患者样本,以及在精神药物中毒组中,p<0.05,第 1 天 CK 水平被证实为一个独立的预测因子,可显著影响住院时间的变异性 5.2%(R2=0.052),而 20%(R2=0.200)。在急性中毒导致的横纹肌溶解症中,检查肌酸激酶很重要。与化学物质中毒相比,精神活性物质中毒的急性中毒患者的肌酸激酶水平更高。在精神活性物质中毒组中,肌酸激酶作为一个独立的预测因子,显著影响住院时间。