The predictive value of creatine phosphokinase and alkaline phosphatase in identification of heterotopic ossification in patients after spinal cord injury.
The predictive value of creatine phosphokinase and alkaline phosphatase in identification of heterotopic ossification in patients after spinal cord injury.
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DOI：
10.1053/s0003-9993(03)00347-2
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发表时间：
2003-11
影响因子：
4.3
通讯作者：
Rajendra S Singh-;M. Craig;C. Katholi;A. Jackson;J. Mountz
中科院分区：
文献类型：
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作者：
Rajendra S Singh-;M. Craig;C. Katholi;A. Jackson;J. Mountz
目的探讨血清肌酸磷酸激酶（CPK）和碱性磷酸酶（ALP）水平对脊髓损伤（SCI）患者髋部异位骨化（HO）的预测价值。设计前瞻性队列研究。单位：一级创伤中心。对象18例成人急性创伤性脊髓损伤患者。如果患者患有已知会导致酶水平升高的内科或外科疾病，则将其排除。不适用。主要观察指标：伤后3周左右拍摄常规髋关节X线片，伤后3 ~ 6个月再拍摄一次。SCI后约3周测量血清ALP和CPK。患者随后被分为2组：第1组由发生HO的患者组成，第2组由未发生HO的患者组成。结果：两组的初始X线片均未显示HO证据。术后3 ~ 6个月X线片显示7例出现HO。初始评估时，第1组的CPK水平明显高于第2组（R=.947，P<.0024），并且与HO的严重程度相关。两组间血清ALP水平与随后发生HO之间无相关性（P= 0.07）。结论血清CPK水平升高对HO有一定的预测价值。
OBJECTIVE To determine the predictive value of serum levels of creatine phosphokinase (CPK) and alkaline phosphatase (ALP) in identifying patients with spinal cord injury (SCI) who are at risk to develop heterotopic ossification (HO) at the hips. DESIGN Prospective cohort study. SETTING Tertiary-care level I trauma center. PARTICIPANTS Consecutive sample of 18 adults with acute traumatic SCI. Patients were excluded if they had medical or surgical conditions that are known to cause elevated enzyme levels. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Conventional hip radiographs were taken approximately 3 weeks after injury and again from between 3 to 6 months after injury. Serum ALP and CPK were measured approximately 3 weeks after SCI. Patients were later separated into 2 groups: group 1 was comprised of those who developed HO and group 2 was comprised of those who did not. RESULTS The initial radiographs showed no evidence of HO in either group. The radiographs taken at 3 to 6 months showed HO in 7 of 18 patients. The levels of CPK at the initial evaluation were significantly higher (R=.947, P<.0024) in group 1 than in group 2 and correlated with the severity of HO. There was no correlation between serum ALP levels and subsequent development of HO between the 2 groups (P=.07). CONCLUSION Elevated serum levels of CPK have value in predicting the HO.