糖尿病急性代谢并发症与非创伤性横纹肌溶解症

糖尿病酮症酸中毒（DKA）与高渗性高血糖状态（HHS）是糖尿病最为严重的急性代谢并发症,在DKA或HHS患者中有50%可合并非创伤性横纹肌溶解症（NRML）,严重者可导致急性肾功能衰竭。DKA或HHS介导NRML的机制可能包括肌肉缺血、缺氧,电解质紊乱及酸碱失衡,感染,应用羟甲戊二酸单酰CoA还原酶抑制剂等。因早期诊断并及时治疗常可逆转病情发展,从而避免发生严重并发症,降低死亡率,因此对NRML及时并准确的诊断很重要。

Acute metabolic complications of diabetes mellitus and noninjuria rhabdomyolysis

Diabetic ketoacidosis(DKA)and hyperosmolar hyperglycemic state(HHS)are acute metabolic complications of diabetes mellitus.Noninjuria rhabdomyolysis(NRML)occurs in as many as 50% of patients presenting with DKA or HHS and may induce acute renal failure.The mechanism of DKA or HHS-mediated muscle injury is uncertain.Theories include insufficient energy and oxygen delivery to muscle,electrolyte disturbances,acid-base imbalance,infection,treating with HMG-CoA reductase inhibitors,etc.Timely and accurate diagnosis of NRML is important,because significant potential complications may be averted with appropriate therapy.