Levin R, Pascuzzi R M, Bruns D E, Boyd J C, Toly T M, Phillips L H
Muscle Nerve. 1987 Mar-Apr;10(3):242-5. doi: 10.1002/mus.880100308.
The electromyographic (EMG) exam and creatine kinase (CK) are commonly used to evaluate patients with neuromuscular diseases. Prior studies have demonstrated minimal elevation of CK following monopolar needle examination, indicating that a false positive elevation does not occur in normal individuals. We studied the magnitude and time course of CK change resulting from concentric (CNEMG) and monopolar (MNEMG) needle EMG examination on healthy volunteers. CK increased in all subjects following CNEMG and MNEMG. Statistically significant mean CK elevations over baseline were observed at 4, 8, 12, and 24 hours for CNEMG and at 12 and 24 hours for MNEMG. Maximum elevation occurred at 12 and 24 hours for both CNEMG (mean, 178% of baseline) and MNEMG (mean, 134% of baseline). CK returned to baseline by 48 to 72 hours. In 25-30% of subjects CK elevation significantly exceeded the normal range. The magnitude of CK elevation is greater and the time course more prolonged than previously reported. CK measurements should be avoided 4 to 48 hours following CNEMG because of the potential for false positive results. Measurements immediately after and at 72 hours are not affected by the CNEMG or MNEMG. The time course for CK change following MNEMG is similar to CNEMG, but the magnitude is less.
肌电图（EMG）检查和肌酸激酶（CK）常用于评估神经肌肉疾病患者。先前的研究表明，单极针电极检查后CK仅有轻微升高，这表明正常个体不会出现假阳性升高。我们研究了同心针电极肌电图（CNEMG）和单极针电极肌电图（MNEMG）检查对健康志愿者CK变化的幅度和时间进程。CNEMG和MNEMG检查后所有受试者的CK均升高。CNEMG检查后，在4、8、12和24小时观察到CK相对于基线有统计学意义的平均升高，MNEMG检查后在12和24小时观察到。CNEMG和MNEMG的最大升高均出现在12和24小时（CNEMG平均为基线的178%，MNEMG平均为基线的134%）。CK在48至72小时恢复到基线水平。25%至30%的受试者CK升高显著超过正常范围。CK升高的幅度比先前报道的更大，时间进程更长。由于可能出现假阳性结果，CNEMG检查后4至48小时应避免进行CK测量。检查后立即及72小时时进行测量不受CNEMG或MNEMG的影响。MNEMG检查后CK变化的时间进程与CNEMG相似，但幅度较小。
