The aim of this study was to analyze the relationship of ratio of CK-MB/CK on Child-Pugh classification in patients with cirrhosis.

The patients with cirrhosis who admitted to our hospital from April 2013 to July 2013 were enrolled in this study.A total of 121 cases were enrolled in this study, average age was 56.67±10.88 years old, with 89 of whom were male and 72 of whom were hepatitis B cirrhosis.The Child-Pugh score was used to assess the prognosis of cirrhosis, and patients were classified into Child-Pugh class A to C. Inclusion criteria included: (1)diagnosis of cirrhosis was made according to the National Infectious and Parasitic Diseases Conference; (2)no previous histories of coronary heart disease, hypertension or heart disease; (3)without ST-T changes in electrocardiogram; (4)the levels of cTnI was normal. Exclusion criteria included: (1)history of splenectomy; (2)hepatocellular carcinoma, liver transplant, carried interferon, immunosuppressive or anti-viral treatment; (3)the presence of blood diseases or serious infectious diseases. Baseline clinical characteristics including age, gender distribution, hepatic functions and routine examinations were recorded. The kinetic enzymatic method and immunosuppression method were used to measure the levels of CK and CK-MB respectively. The levels of CK and CK-MB, as well as ratios of CK-MB/CK were compared among groups. Ordinal Logistic regression analysis was used to analyze the relationship of CK-MB/CK ratio on Child-Pugh classification.

Patients in Child-Pugh C group were older than those in Child-Pugh A and B groups (P=0.021). There were significant differences in γ-GT(195.61±20.32, 240.56±27.23, 265.15±17.48, F=77.149, P<0.05), CK[(82.18±23.60)U/L, (98.22±33.13)U/L, (117.05±27.31)U/L, F=23.248, P<0.05)], CK-MB[(29.77±12.75)U/L, (63.26±36.35)U/L, (69.76±27.05)U/L, F=20.588, P<0.05)], ratio of CK-MB/CK(0.36±0.08, 0.54±0.26, 0.75±0.30, F=31.558, P<0.01), prothrombin activity[(71.77±14.88)%, (56.82±16.61)%, (41.73±11.43)%, F=54.483, P<0.05)], hemoglobin[(138.21±8.24)g/L, (108.16±23.60)g/L, (78.52±23.64)g/L, F=95.752, P<0.05)] and platelet[(153.86±92.59)g/L, (108.38±51.90)g/L, (93.88±54.51)g/L, F=12.965, P<0.05)] among groups. No significances in gender distribution, hepatic diseases, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Creatinine (SCr) were found among groups in this study. Ordinal Logistic regression analysis found that there was a relationship of CK-MB/CK ratio on Child-Pugh classification in patients with cirrhosis, with the value of OR was e^{- 0.98}=0.375. This result indicated that the probability of Child-Pugh C in cirrhosis patients with the value of CK-MB/CK>0.30 was 2.67 times higher than those when less than 0.30.

The ratio of CK-MB/CK is significantly associated with Child-Pugh classification in patients with cirrhosis.