Sefer S, Degoricija V, Bilić B, Trotić R, Milanović-Stipković B, Ratkovi-Gusić I, Kes P
Department of Nephrology and Dialysis, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Acta Med Croatica. 1999;53(4-5):199-202.
Acute renal failure (ARF) is a severe complication of acute CO poisoning which, combined with other organ lesions, may result in lethal outcome. In all vague cases of ARF with nontraumatic rhabdomyolysis, CO poisoning should be considered as a possible etiologic factor. The diagnosis is made on the basis of several simple laboratory tests: determination of carboxyhemoglobin concentration, demonstration of myoglobin in urine or pigment granulated cylindres in urinary sediment, positive orthotoluidine test, and high CPK values originating from skeletal musculature. Many authors report on excellent prognosis in ARF due to nontraumatic rhabdomyolysis of various causes. Our case report shows that the prognosis of CO poisoned patient greatly depends on timely and appropriate treatment, severity of damage to other organs, and success of the treatment of complications such as hospital infections.
急性肾衰竭(ARF)是急性一氧化碳中毒的严重并发症,它与其他器官损伤相结合,可能导致致命后果。在所有伴有非创伤性横纹肌溶解的ARF模糊病例中,应将一氧化碳中毒视为可能的病因。诊断基于几项简单的实验室检查:测定碳氧血红蛋白浓度、尿液中肌红蛋白的检测或尿沉渣中色素颗粒管型的显示、正甲苯胺试验阳性以及源于骨骼肌的高肌酸磷酸激酶(CPK)值。许多作者报道,各种原因引起的非创伤性横纹肌溶解导致的ARF预后良好。我们的病例报告表明,一氧化碳中毒患者的预后很大程度上取决于及时恰当的治疗、其他器官损伤的严重程度以及医院感染等并发症的治疗效果。