有关非创伤性横纹肌溶解症致急性肾功能衰竭的八个问题

结合9例非创伤性横纹肌溶解症致急性肾功能衰竭的临床分析,作者认为非创伤性横纹肌溶解症并非罕见,对有病因者,检查血清磷酸肌酸激酶,尿肌红蛋白以及必要的肌肉活检等多可诊断,应预防和警惕急性肾衰。特别是非少尿性急性肾衰的发生,对已发生急性肾衰者,经病因处理,支持疗法和必要的透析,病人多可痊愈。文章着重讨论了非创伤性横纹肌溶解症致急性肾衰的发生机制,诊断及治疗问题等。

Acute renal failure in nontraumatic rhabdomyolysis

We reviewed 9 patients with nontraumatic rhabdomyolysis developed acute renal failure.The results were 5 of male cases which involved alcohol intoxications and 4 of female cases induced by diabetic ketoacidosis,seizure,miltown intoxication and opium poisoning,respectively.By etiological treatment of hemodialysis,8 cases were cured and one died.Authors suggested that nontraumatic rhabdomyol- ysis was not rare in China,which can be diagnosed through measuring serum cre- atine phosphokinase(CPK),myoglobin as well muscle biopsy in the patients with the etiologies of rhabdomyolysis.It should be aware of rhabdomyolysis induced acute renal failure,especially nonoliguric acute renal failure.The most patients with acute renal failure induced by nontraumatic rhabdmyolysis can be cured und- er etiologic treatment,support treatment and dialysis.The paper also reviewed the up-to-date literatures in nontraumatic rhabdomyolysis abroad.