Visweswaran P, Guntupalli J
Department of Internal Medicine, University of Texas Medical School, Houston, USA.
Crit Care Clin. 1999 Apr;15(2):415-28, ix-x. doi: 10.1016/s0749-0704(05)70061-0.
Dissolution of the skeletal muscle, resulting in extravasation of the intracellular toxic metabolites into the circulatory system, and the accompanying manifestations, constitutes the clinical syndrome of rhabdomyolysis. The most frequent complication of this syndrome is acute renal failure, and its most life threatening side effects are hyperkalemia and metabolic acidosis. Intracellular release of free iron from hemeprotein and the oxidant stress is the principle mechanism by which the proximal tubular cytotoxicity is produced. The potential pathogenic mechanisms and the strategies to prevent rhabdomyolysis induced acute renal failure are discussed in this article.
骨骼肌溶解,导致细胞内毒性代谢产物渗入循环系统及其伴随表现,构成横纹肌溶解症的临床综合征。该综合征最常见的并发症是急性肾衰竭,其最危及生命的副作用是高钾血症和代谢性酸中毒。血红素蛋白中游离铁的细胞内释放和氧化应激是产生近端肾小管细胞毒性的主要机制。本文讨论了潜在的致病机制以及预防横纹肌溶解症所致急性肾衰竭的策略。