中华皮肤科杂志 ›› 1983, Vol. 16 ›› Issue (2): 91-95.

• 论著 • 上一篇    下一篇

成人皮肌炎血清酶变化和病情关系的研究

俞宝田1, 李洪迥1, 中国医学科学院首都医院检验科生化室2   

  1. 1. 中国医学科学院首都医院, 皮肤科;
    2. 中国医学科学院首都医院, 检验科, 生化室
  • 出版日期:1983-06-15 发布日期:1983-06-15

Study of the correlation between serum enzyme changes and patients’s condition in adult dermatomyositis

Yu Baotian1   

  • Online:1983-06-15 Published:1983-06-15

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摘要： 作者收集了1976-1981年的成人皮肌炎52例,对这些患者作了详细的血清酶〔肌酸磷酸激酶(CPK)、谷草转氨酶(GOT)、乳酸脱氢酶(LDH)、谷丙转氨酶(GPT)及醛缩酶(ALD)〕的测定.在皮肌炎的活动期,血清酶升高者:CPK51.4%.ALD88.9%、GOT72.2%,LDH96.7%,GPT54.8%.稳定期患者血清酶正常者:CPK100%,ALD93.3%.GOT69.2%,LDH40%,GPT95.5%.CPK对皮肌炎特异性续但敏感性稍差.LDH敏感性好,但特异性差.ALD和GOT对皮肌炎的诊断和判断病情较好.还观察了患者肌功能与血清酶活性的关系,其结果示ALD与GOT活性与不同肌功能存在非常显著的差异(P<0.01)>CPK活性也有显著差异(P<0.05).而LDH活性则无明显差异.用强的松治疗后,肌功能进步一级平均需2.2月的时间.使血请酶恢复正常的平均天数为CPK50天、ALD82天、GOT72天、GPT77天,而LDH下降至正常则非常慢.上述资料示肌功能的进步与血清酶活性的下降相平行.作者认为肌功能的检查与血清酶活性的测定可作为治疗适当与否的两个主要指标.

Abstract: 52 cases of adult dermatomyositis Were collected from 1976 to 1981.A detailed study of serum enzymes creatine phosphokinase(CPK),glutamic oxalacetic transaminase(GOT),lactate dehydrogevase(LDH),glutamic pyruvic transaminase(GPT) and aldolase(ALD)is presented,During active stage of the disease,elevated values of serum enzymes are as follows:CPK51.4%,ALD88.9%,GOT 72.2%.LDH96,7% and GPT54.8%.During remission,100% of CPK,93.3% of ALD,69.2% of GOT,40% of LDH and 95.5% of GPT return to normal,The CPK is more specific,but riot very sensitive for dermatomyosiits:The LDH is more sensitive,but less specific for dermatomyositis.The ALD and GOT are the most reliable of serum enzymes and conform best with the clinical course of the disease.The rzlatioa between various grades of patients' impaired muscular function and serum enzyme activity has been studied.The results are as follows:ALD and GOT show highly significant difference(P<0.01);CPK also shows significant difference(P<0.05});while LDH shows no significant difference(P>0.05) between the various grades of impaired muscular function and the levels of serum enzyme activity.After treatment with prednisone,patients' muscle strength improved one grade,in an average period of 2.2 months.The average time required for each serum enzyme to reach normal level is as follows: CPK 50 days,ALD 82 days,GOT 72 days and GPT 77 days.But the normalization of LDH was very slow.These data show that the improvement of muscle strength runs parallel with the descent of serum enzyme levels.Therefore both muscle strength and the level of serum enzyme can be taken as indices of adequacy of treatment,.