Blood CPK indicator: what is it, reasons for changes

Standard tables

The concentration of creanite kinase depends on the patient's gender and age. To a lesser extent race, origin.

Among women

The calculations are approximate. In fact, you need to take into account the individual characteristics of the body, body constitution, height, weight, general health and others.

Only a specialist can cope. When he clarifies all the necessary points. This is possible during a face-to-face appointment.

In men

In men, the CPK norm in a blood test is initially two times higher than in women and ranges from 270 to 300 U/liter.

Why is that? The reason is that the total muscle volume is greater and the force of muscle contraction is greater. This is due to hormonal characteristics and body constitution. Therefore, energy metabolism goes faster.

It is impossible to say more precisely for the same reasons.

In children

CPK levels in the blood of children vary, but there is still no significant variation in gender. At birth, the rates are highest, and over time they fall by 2-3 times.

Detailed data is presented in the table:

Levels are approximate. It is better to leave the decoding to a specialist. The question is complex. There are no universal indicators.

Indications and results

Indications for analysis are:

• Meloxicam: use of intramuscular form in rheumatology

• early diagnosis of myocardial infarction (analysis is required within the next 2-4 hours);
• differential diagnosis of myocardial infarction, when this attack is combined with a mild or uncomplicated attack of angina.

In addition, this test is prescribed to all patients who are being treated for any heart disease in order to exclude the possibility of a heart attack. It is knowledge of the level of CPK (what it is, described above) that will help specialists determine the condition of the heart. An increase in this substance in the blood can signal possible heart problems. If this phenomenon is permanent, then the doctor in most cases decides on preventive treatment, which will stop the development of the disease in the future.

Blood CPK (what it is, you can find out at the beginning of the article) is elevated in the following cases:

• myocardial infarction (increased values ​​are diagnosed in the first 2-4 hours, the maximum is reached after 24 hours; after 3-6 days the value decreases, but normalization does not occur);
• muscle dystrophy;
• Reye's syndrome (acute hepatic encephalopathy);
• state of shock;
• various poisonings, in particular with alcohol and sleeping pills;
• infectious lesions of the myocardium.

A reduced level of CPK in the blood (what it is, described above) is observed with a decrease in muscle mass, a sedentary lifestyle, and also acts as an indirect sign of the development of thyrotoxicosis (intoxication with thyroid hormones that are produced by the thyroid gland).

When is the test prescribed?

CPK is found in skeletal muscle, smooth muscle, heart and brain. Therefore, if an increased result is obtained, serious diseases such as myocardial infarction, chronic muscle diseases and even oncology can be suspected.

Creatine phosphokinase (CPK) - 250 rub.

Urgent analysis - 500 rub.

Deadlines

Normal – 1 day.

Urgent – ​​1.5 – 2 hours.

Taking blood from a vein is paid separately - 300 rubles.
(If several tests are performed simultaneously, the service for collecting biomaterial is paid once)

Indications

• Comprehensive diagnosis of diseases associated with muscle cell damage.
• To confirm myocardial infarction and during the recovery period to assess the condition of the heart muscle.
• If oncology is suspected as part of a comprehensive diagnosis and to assess the effectiveness of treatment.
• To assess the severity of muscle injury.

To obtain an accurate result, you must strictly follow the preparation tips. Laboratory equipment is no less important, so it is recommended to contact only those clinics that are equipped with modern equipment.

Material for analysis

venous blood serum (avoid hemolysis)

Preparing for the study

As a rule, before taking the analysis you need to do the following:

• Tell your doctor about the medications you are taking; they may need to be stopped temporarily. If it is impossible to cancel, then you need to donate blood before taking the medicine in the morning.
• Avoid eating 8 hours before blood sampling. Therefore, it is best to take the test in the morning, on an empty stomach.
• The day before blood sampling, you must avoid fatty, fried, spicy and salty foods. Alcohol and kvass are strictly excluded.
• It is worth telling your doctor about a recent ultrasound or x-ray. These examinations may affect the results.
• It is important to avoid intense physical activity - after exercise, muscle cells are damaged, which leads to an increase in enzyme levels. This may make it difficult for your doctor to interpret the results.
• It is recommended to avoid emotional stress before donating blood.

Reasons for the increase

An increase in CPK concentration is more common than a decrease. Basically, such a deviation begins with degenerative processes.

• Myocarditis. Inflammatory damage to the heart muscle. It has an infectious, less often non-septic nature. Creatine kinase in the blood is elevated due to tissue destruction. The enzyme passes from bound to free form and is found in the blood in large volumes.

Normally, the level of CPK MB is about 2% of the total amount of creatine phosphokinase. The severity of the disease is judged by the concentration of the substance and the degree of deviation from the norm.

• The same goes for a heart attack. This is an emergency condition in which the muscle layer is rapidly destroyed from lack of nutrition and cellular respiration. A sharp increase in CPK is observed immediately after the pathological process has developed.

Then the level gradually decreases. This takes more than one day, but sometimes even several weeks. Doctors can help correct energy metabolism. If you systematically use protectors and other medications, recovery will go faster.

• Autoimmune muscle damage. Quite a rare occurrence. In this condition, the body's muscles are destroyed by its own defense system. The degree of disorder varies. In the mildest cases it is a localized process. In more complex ones - generalized. When many muscles are involved.

CPK MM enters the bloodstream, the concentration increases, this immediately becomes noticeable. Moreover, this modification makes up the vast majority of the total mass of the compound in the channel.

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• The reason why creatine kinase in the blood is elevated may also be a stroke, an acute disorder of cerebral circulation. The essence of the phenomenon is approximately the same as during a heart attack. Only the localization is different. Parts of the brain die.

CPK BB, a specific isoenzyme found in nerve fibers, does not increase. The blood-brain barrier interferes.

However, due to violations of the central regulation of energy exchange processes, the number of other CPK modifications changes. This is rather an indirect consequence, but it is clearly noticeable. Everything returns to normal after a few weeks.

• Consuming large amounts of alcohol. An increase in creatine phosphokinase means that intoxication has occurred, and the stronger the poisoning, the more seriously energy metabolism suffers.

The study is carried out twice. The first time is before treatment begins (detoxification measures). The second one comes after. To investigate how much ATP synthesis has been restored.

You can evaluate the level later, in dynamics. This is important if, for example, the patient received critically dangerous poisoning, and it was barely possible to return him to normal. The question remains at the discretion of specialized doctors.

• Use of certain drugs. CK may also increase when taking certain medications - this is a side effect. Usually it does not pose a serious danger, but exceptions to the rule are possible. The same effect occurs with psychotropic drugs. Antidepressants, neuroleptics. To a lesser extent with tranquilizers.
• Another reason for increased creatine kinase in the blood is a recent operation. The more severe the intervention, the more difficult the recovery, the more serious the disturbances in energy metabolism. The main sign of this is an increase in creatine phosphokinase.

CPK may be higher than normal due to the destruction of muscles, nerve tissue, and myocardial structures. In each case, a certain fraction of the enzyme grows. Except perhaps for the brain, since the substance cannot leave the blood-brain barrier.

To determine what's wrong, you need to conduct a full diagnosis. A group of specialists should deal with this: a neurologist, a cardiologist and others.

Attention:

The increase in CPK does not help the body at all, and does not add health. Although it may seem so at first glance.

The fact is that increasing concentration does not increase energy metabolism in itself. Most often, enzyme fractions are released during tissue destruction. Nervous, muscular.

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They act as a kind of depot, storage facility. During destruction, active release occurs. But the substances remain inactive. They have nothing to speed up. There is no more substrate.

In addition, the underlying disease itself may be a factor in insufficient energy metabolism. A paradoxical situation arises: CPK in the blood is elevated, and the process is extremely slow.

Creatine kinase (Creatine phosphokinase CPK)

Creatine kinase is an enzyme that stimulates the conversion of creatine into creatine phosphate and provides energy for muscle contraction.

Research method

UV kinetic test.

Units

U/L (unit per liter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

• Do not eat for 12 hours before the test.
• Avoid physical and emotional stress for 30 minutes before the test.
• Do not smoke for 30 minutes before donating blood.

General information about the study

Creatine kinase is an enzyme that catalyzes the transfer of a phosphoryl residue from ATP to creatine to form creatine phosphate and ADP. The reaction, catalyzed by creatine kinase, provides energy for muscle contraction. There are creatine kinase contained in the mitochondria and cytoplasm of cells.

The creatine kinase molecule consists of two parts, which can be represented by one of two subunits: M, from the English muscle, and B, brain. Thus, in the human body creatine kinase exists in the form of three isomers: MM, MB, BB. The MM isomer is found in skeletal muscles and myocardium, MV - mainly in the myocardium, BB - in brain tissue, and in small quantities in any cells of the body.

In the blood of a healthy person, creatine kinase is present in small quantities, mainly in the form of the MM isomer. Creatine kinase activity varies with age, gender, race, muscle mass, and physical activity.

Creatine kinase enters the bloodstream in large quantities when the cells containing it are damaged. At the same time, based on the increase in the activity of certain isomers, one can conclude which tissue is affected: MM fraction – muscle damage and, to a lesser extent, heart damage, MV fraction – myocardial damage, BB fraction – cancer. Typically, tests are done for total creatine kinase and its MB fractions.

Thus, an increase in creatine kinase in the blood allows us to draw a conclusion about a tumor process, damage to the heart or muscles, which in turn can develop both with primary damage to these organs (during ischemia, inflammation, trauma, degenerative processes), and as a result of their damage during other conditions.

Muscle diseases in which cells are destroyed are myositis, myodystrophy, injuries, especially when compressed, bedsores, tumors, intense muscle work, including what occurs during convulsions. In addition, there was an inverse relationship between the levels of thyroid hormones and creatine kinase: with a decrease in T3 and T4, the activity of creatine kinase increases and vice versa.

When is the study scheduled?

• For symptoms of coronary heart disease.
• With symptoms of myocardial infarction, in particular with a blurred clinical picture, especially with a recurrent infarction, atypical localization, pain or ECG signs, difficulty in differential diagnosis with other forms of coronary heart disease.
• For hypothyroidism.
• For symptoms of myositis, myodystrophy, myopathy.
• When planning pregnancy by a woman whose family had Duchenne myopathy patients.
• For diseases that can lead to damage to the heart or muscular system.

What do the results mean?

The results of the analysis indicate the presence or absence of damage to the myocardium, skeletal muscles, tumor process, and thyroid diseases. The correct interpretation of the obtained indicators allows us to draw a conclusion about the form of the lesion and the degree of its severity.

Reasons for increased total creatine kinase activity:

• myocardial infarction,
• myocarditis,
• myocardial dystrophy,
• polymyositis,
• dermatomyositis,
• muscular dystrophy,
• injuries, burns,
• hypothyroidism,
• tumor process in the body,
• tumor disintegration,
• taking dexamethasone, statins, fibrates, amphotericin B, painkillers, alcohol, cocaine,
• intense physical activity,
• seizures, status epilepticus,
• surgical interventions.

Reasons for decreased activity of total creatine kinase:

• decrease in muscle mass,
• alcoholic liver damage,
• collagenoses (for example, rheumatoid arthritis),
• hyperthyroidism,
• taking ascorbic acid, amikacin, aspirin,
• pregnancy.