免疫抑制法和免疫荧光定量法在肌酸激酶同工酶活性测定中的应用价值

陈伟君+++叶昌远+++程晓玲

[摘要]目的 探讨免疫抑制法和免疫荧光定量法在肌酸激酶同工酶活性测定中应用价值。方法 选取我院2014年1月～2015年12月收治的70例患者，根據疾病类型分为甲组及乙组，各35例。甲组为急性心肌梗死患者且发病时间在4～8 h，乙组为非心源性疾病且肌酸激酶同工酶（CK-MB）活性升高的患者，分别使用速率法及免疫抑制法测定两组患者的肌酸激酶（CK）活性及CK-MB活性，用免疫荧光定量法测试CK-MB质量浓度。结果 甲组CK活性[（585.0±102.0）U/L]、CK-MB活性[（85.0±22.0）U/L]与CK-MB质量浓度[（18.5±2.2）ng/ml]均升高；乙组CK活性正常，CK-MB活性升高，但CK-MB质量浓度不升高，结果不一致。结论 CK-MB的活性测定方法一般均为免疫抑制法，但由于方法学的局限性，可引起测定结果假性升高，出现异常升高时，及时和临床取得联系，可结合患者的病情，进一步用免疫荧光定量测定CK-MB的质量浓度，为患者提供更准确的检测结果。

[关键词]免疫抑制法；免疫荧光定量法；肌酸激酶同工酶

[中图分类号] R446.1 [文献标识码] A [文章编号] 1674-4721（2017）02（c）-0118-03

Application value of immunosuppression and immune fluorescence quantitative method in the determination of creatine kinase isoenzyme

CHEN Wei-jun YE Chang-yuan CHENG Xiao-ling

Department of Laboratory，Heyuan Triditional Chinese Hospital in Guangdong Province，Heyuan 517000，China

[Abstract]Objective To explore the application value of immunesuppression and immune fluorescence quantitative method in the determination of creatine kinase isozyme activity.Methods 70 patients in our hospital from January 2014 to December 2015 were selected and divided into two groups according to the disease type，with 35 cases in each group.The A group was acute myocardial infarction （AMI） and the duration was in 4-8 h；the B group was non-cardiac disease and high CK-MB activity.The CK activity and CK-MB activity of patients in two groups were respectively determinated using the velocity method and immunesuppression method，and the quality of CK-MB was determined using immune fluorescence quantitative method.Results The CK activity [（585.0±102.0）U/L]，CK-MB activity [（85.0±22.0） U/L] and quality of CK-MB [（18.5±2.2） ng/ml] of patients in group A were all raised；the CK activity of patients in group B was normal，the CK-MB activity was raised with a inconsistent results that the quality of CK-MB was not raised.Conclusion The method to determinate the CK-MB activity in general is immunesuppression method.But because of the limitation of the methodology，the activity of CK-MB may falsely raise.On this occasion，doctors should combine the clinic and patients′conditions，using the immune fluorescence quantitative method to make further determination of the quality of CK-MB，in order to provide more accurate test results for the patients.

[Key words]Immunesuppression method；Immune fluorescence quantitative method；Creatine kinase isoenzyme临床上，一般用天冬氨酸氨基转移酶（AST），乳酸脱氢酶（LDH），α-羟丁酸脱氢酶（α-HBDH），肌酸激酶（CK）和肌酸激酶同工酶（CK-MB）的活性作为心肌酶谱，主要用于确定心肌缺血坏死或细胞膜的通透性，是衡量心肌受损的指标。CK主要存在于骨骼肌、心肌和脑组织中，CK-MB大量存在于心肌组织中，其他组织和器官中含量很少，所以CK-MB是目前诊断急性心肌梗死（acute myocardial infarction，AMI）的一个极其可靠的生化指标，特异性可达95%乃至更高[1]。正常情况下，CK-MB/CK应<5%，CK-MB升高，≥正常高值的6%，被认为是提示心肌损伤的指标[2] 。……