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1、血清心肌酶谱在重性精神病患者中临床观察何新云龙宇雄彭志娥李惠芝郭君英湖南省安化县精神病防治院湖南安化413522【摘要】目的：探讨血清心肌酶谱(CK、LDH、CK-MB、AST、a-HBD)与重性精神病患者病情的变化关系,指导临床用药及预防并发症。方法：对符合中国精神障碍分类与诊断标准第3版（CCMD－Ⅲ）诊断标准的60例住院重性精神病患者，分别于入院24h内和1周后进行血清心肌酶谱检测，并采用夏梅兰所译的“阳性症状量表（SAPS）”和“阴性症状量表(SANS)[1]”评分比较,同时根据临床症状的缓解观察分析。结
2、果60例重性精神病患者入院24h内CK、LDH、CK-MB显著高于治疗后，其中肌酸激酶（CK）增高34例，占56.7%。乳酸脱氢酶（LDH）增高8例,占13.3%，肌酸激酶同工酶（CK－MB）增高3例，占5%。入院时CK和LDH同时增高的7例,占11.66%。同时用SAPS和SANS症状量表评分其减分率有明显变化。结论 重性精神病患者急性期血清心肌酶谱有56.7%的增高、以血清CK、LDH、CK-MＢ增高为多见，其病情严重程度,病程及用药与血清心肌酶谱的高低有显著关系(P<0.01)，阳性症状（SAPS）和阴性症
3、状（SANS）量表分值与心肌酶谱降低关系密切。故此，重性精神病患者进行心肌酶谱检测，对观察疗效、指导临床安全用药、防止心脑血管意外的发生具有临床意义。【关键词】重性精神病；血清心肌酶；临床检验观察【abstract】objective:tostudytheserummyocardialenzyme(CK,LDH,CK-MB,AST,a-HBD)andheavynatureofmentalillnessconditionchangesrelationship,guidingclinicaldrugandtoprev
4、entcomplications.Methods:toaccordwithChina'smentaldisordersclassificationanddiagnosisstandardthirdedition(CCMD-Ⅲ)diagnosisstandard60patientsinhospitalofheavymentalpatients,within24hrespectivelyadmissionandafter1weekserummyocardialenzymedetection,andbyusingthe
5、XiaMeiLanthetranslationof"positivesymptomsscale(SAPS)"and"negativesymptomsscale(SANS)[1]"scoreis,atthesametime,accordingtothestudytoanalyzetheclinicalsymptomrelief.Results60casesofheavymentalillnesswereadmittedtothehospitalwithin24hCK,LDH,CK-MBsignificantlyhi
6、gheraftertreatment,includingcreatinekinase(CK)heighten34cases,accountingfor56.7%.Lactatedehydrogenase(LDH)increasein8cases,13.3%,creatinekinaseisozymes(CK-MB)increasein3,5%.AdmissionCKandLDHalsoincreaseof7cases,accountingfor11.66%.AtthesametimeusetheSAPSandSA
7、NSsymptomsratingscalethedeductionrateareobviouslydifferent.Conclusionheavymentalillnessintheacutephaseofserummyocardialenzymeofincreasedby56.7%,andserumCK,LDH,CK-MBformanyseeincreased,itsillnessseverity,durationanddruguseandserummyocardialenzymehasasignifican
8、trelationshipbetweenthehighandlow(P<0.01),positivesymptoms(SAPS)andnegativesymptoms(SANS)scalescoreandmyocardialenzymeclosetothelower.Therefore,theheavysexualpsychiatricpatientsformyocard
