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目的探讨血清肌酸激酶(CK)及同工酶测定在胎盘植入中的诊断价值。方法2004年1月至2007年1月在中山市人民医院测定33例正常产妇及85例临床疑诊胎盘植入产妇血清CK及同工酶。结果胎盘植入产妇31例血清CK水平为(143.1±28.5)U/L,其中MB13%,MM87%,BB未测出,胎盘粘连产妇26例血清CK水平为(76.3±25.4)U/L,其中MB4%,MM96%,BB未测出;其他产妇38例血清CK水平为(69.3±24.4)U/L,其中MB5%,MM95%,BB未测出。正常产妇33例血清CK水平为(68.4±24.4)U/L,其中MB4.5%,MM94.5%,BB未测出。胎盘植入组产妇血清CK水平明显高于胎盘粘连组、其他产妇组和正常产妇组,差异有统计学意义(P<0.01),且其中MB型所占比例明显升高,各组BB型均未测出,以CK活性为96U/L作为诊断胎盘植入的界值,敏感性为91.3%,特异性为89.0%,阳性预测值83.8%,阴性预测测值96.9%。结论测定血清肌酸激酶及其同工酶在胎盘植入中的产前诊断有重要的临床意义。
Objective To investigate the diagnostic value of serum creatine kinase (CK) and isoenzyme in placenta accreta. Methods From January 2004 to January 2007, 33 cases of normal maternal and 85 cases of clinically suspected maternal serum CK and isoenzyme were measured in Zhongshan People ’s Hospital. Results Serum CK levels in the 31 cases of placenta accreta were (143.1 ± 28.5) U / L, MB13%, MM87%, BB were not detected, serum CK level was (76.3 ± 25.4) U / Among them, MB4%, MM96% and BB were not detected. Serum CK levels of other 38 maternal women were (69.3 ± 24.4) U / L, of which MB5%, MM95% and BB were not detected. The serum levels of CK in the 33 cases of normal women were (68.4 ± 24.4) U / L, MB4.5%, MM94.5%, BB not detected. The level of serum CK in placenta accretae group was significantly higher than that in placenta adhesion group, other maternal group and normal maternal group (P <0.01), and the proportion of MB genotype was significantly increased Not detected, CK activity of 96U / L as the cut-off point for the diagnosis of placenta accreta, the sensitivity was 91.3%, the specificity was 89.0%, the positive predictive value of 83.8%, the negative predictive value of 96.9%. Conclusion The determination of serum creatine kinase and its isoenzyme in prenatal diagnosis of placenta accreta has important clinical significance.