Shimoda-Matsubayashi S, Yagi K, Tanabe H
Department of Neurology, Juntendo University School of Medicine.
Rinsho Shinkeigaku. 1996 Aug;36(8):935-9.
In the long course of Parkinson disease, we encounter the elevation of serum creatine kinase (CK) occasionally. Such elevation was not necessarily accompanied by severe symptoms as malignant syndrome. To delineate the basis of its situation, we selected the patients showing CK-elevation from 697 cases of Parkinson disease who had entered our hospital and their serum CK level had been measured. The cases with common cause of CK-elevation like trauma or myocardial infarction were excluded in advance. Those patients with CK-elevation were investigated with reference to age, gender, severity, duration of illness, dementia, and psychiatric symptoms retrospectively. High CK level was observed in 95 cases who were composed predominantly of advanced male patients. No obvious anticipatory cause of CK-elevation like a modification of anti-parkinson drug was recognized in 65 cases. On the other hand, CK-elevation caused by the modification of anti-parkinson drug was recognized in 10 cases. CK-elevation was observed in patients with dementia, delirium, and hallucination at higher rate. Most of these patients with CK-elevation did not show high fever and did not necessarily meet the criteria of malignant syndrome. However, 9 cases who showed marked increase of CK level over 10 times of upper limit of normal value contained some cases who had features of malignant syndrome. In Parkinson disease, especially in advanced cases dopamine may be unstable controlled in a few locations of their brain. Some situation of the disease may elicit imbalance of dopamine in patients' brain and induce CK elevation as in the similar condition in which neuroleptics are administrated.
在帕金森病的漫长病程中，我们偶尔会遇到血清肌酸激酶（CK）升高的情况。这种升高不一定伴有如恶性综合征那样的严重症状。为了阐明其发生的基础，我们从697例来我院就诊且检测过血清CK水平的帕金森病患者中挑选出CK升高的患者。预先排除了因创伤或心肌梗死等CK升高常见原因的病例。对那些CK升高的患者，回顾性地调查了年龄、性别、病情严重程度、病程、痴呆及精神症状。在95例患者中观察到CK水平升高，这些患者主要是老年男性患者。65例患者未发现如抗帕金森药物调整等明显的CK升高预期原因。另一方面，10例患者的CK升高是由抗帕金森药物调整引起的。痴呆、谵妄和幻觉患者中CK升高的发生率更高。这些CK升高的患者大多数没有高热，也不一定符合恶性综合征的标准。然而，9例CK水平显著升高超过正常值上限10倍的患者中，有些具有恶性综合征的特征。在帕金森病中，尤其是晚期病例，大脑某些部位的多巴胺可能控制不稳定。疾病的某些情况可能导致患者大脑中多巴胺失衡，像使用抗精神病药物时的类似情况一样，引发CK升高。
