Serum creatine kinase levels and renal function measures in exertional muscle damage
Serum creatine kinase levels and renal function measures in exertional muscle damage
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DOI：
10.1249/01.mss.0000210192.49210.fc
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发表时间：
2006-04-01
期刊：
影响因子：
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通讯作者：
Thompson, PD
中科院分区：
文献类型：
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作者：
Clarkson, PM;Kearns, AK;Thompson, PD
目的：血清肌酸激酶（CK）水平通常用于判断肌肉损伤的严重程度，并确定何时住院治疗出现劳累性横纹肌溶解症状的患者，以预防肾衰竭。然而，没有CK标准存在，因为有限的信息有关运动引起的CK升高和肾功能。这项研究确定了一个大的受试者群体中CK升高的幅度和运动对肾功能的影响。方法：203名志愿者进行50次手肘屈肌最大离心收缩，采集血样。样品，之前和4.7。运动后10 d。分析了肌肉损伤市场（CK、肌红蛋白（Mb））。乳酸脱氢酶丙氨酸氨基转移酶和天冬氨酸氨基转移酶以及用于测量肾功能（肌酸酐、血尿素氮。磷钾渗透压。结果：运动后肌肉损伤的各项指标均显著增加（P < 0.01）。CK水平为6420。2100.运动后第4、7、10天分别较运动前增加311%（P < 0.01）。Mb为1137。170.运动后第4、7、10天分别较运动前增加28%（P <001）。203名参与者。运动后4 d CK值> 2，000 U L-1的有111只，> 10.000（UL-1）-L-的有51只，用于诊断肌病的水平（例如，他汀类肌炎）和横纹肌溶解。分别他们的任何肾功能指标都没有显著增加。尽管在某些受试者中CK和Mb显著升高。没有人出现明显的肌红蛋白尿或需要治疗肾功能受损。结论：健康人因离心运动而产生的用力性肌肉损伤可导致CK和Mb大幅升高，但不会造成肾脏损害。
Purpose: Serum creatine kinase (CK) levels are commonly used to judge the severity of muscle damage and to determine when to hospitalize patients who present with symptoms of exertional rhabdorriyolysis in order to prevent renal failure. However, no CK standard exists because of the limited information available regarding exercise-induced CK elevation and renal function. This stud), determined the magnitude of CK elevation and the effect on renal function produced by exercise in a large subject group. Methods: Blood samples were obtained from 203 volunteers who performed 50 maximal eccentric contractions of the elbow flexor muscles. The samples, taken before and 4.7. and 10 d after exercise. were analyzed for markets of muscle damage (CK, myoglobin (Mb). lactate dehydrogenase, alanine aminotransferase. and aspartate aminotransferase and for measures of renal function (creatinine, blood urea nitrogen. phosphorus. potassium. osmolality. and uric acid) Results: All indicators of muscle damage increased significantly after exercise (P < 0.01). CK levels were 6420. 2100. and 311% above baseline on days 4, 7, and 10 after the exercise, respectively (P < 0.01). and Mb was 1137. 170. and 28% above baseline on days 4, 7, and 10 after exercise, respectively (P < 0 01). Of the 203 participants. 111 had CK values at 4 d postexercise > 2,000 U L-1 and 51 had values; > 10.000 (UL-1)-L-., levels used to diagnose myopathy (e g., statin myositis) and rhabdomyolysis. respectively. Their were no significant increases in any measure of renal function. Despite marked CK and Mb elevations in some subjects. none experienced visible myoglobinuria or required treatment for impaired renal function. Conclusions: Exertional muscle damage produced by eccentric exercise in healthy individuals can cause profound CK and Mb elevations without renal impairment.