Singh D, Chander V, Chopra K
Pharmacology Division, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India.
Methods Find Exp Clin Pharmacol. 2005 Jan-Feb;27(1):39-48. doi: 10.1358/mf.2005.27.1.875435.
Rhabdomyolysis is a condition caused by skeletal muscle injury and release of muscle cell contents into the circulation. It may result in myoglobinuria, the filtration of myoglobin into the urine, and is often associated with acute renal failure (ARF). Rhabdomyolysis may complicate many disease states. In some, such as crush injury, muscle injury is obvious; in others, such as drug overdose, it may never be apparent. It may occur in the setting of an altered mental status, and even in the conscious patient, it may occur with minimal symptoms or physical findings. Therefore, diagnosis requires a high level of suspicion and appropriate sensitivity to abnormal laboratory values. Many insults can precipitate rhabdomyolysis and myoglobinuria. Disruption of the muscle cell membrane may result from a direct mechanical or toxic insult to the membrane or an inability to maintain ionic gradients across the membrane (as in ischemia or extreme exertion). This article reviews the etiology, pathogenesis, clinical features, complications, and management of rhabdomyolysis, particularly crush injuries in the setting of a major disaster.
横纹肌溶解症是一种由骨骼肌损伤以及肌肉细胞内容物释放进入血液循环所引起的病症。它可能导致肌红蛋白尿，即肌红蛋白滤入尿液，并且常与急性肾衰竭（ARF）相关。横纹肌溶解症可能使多种疾病状态变得复杂。在某些情况中，如挤压伤，肌肉损伤很明显；而在其他情况中，如药物过量，可能根本不明显。它可能在精神状态改变的情况下发生，甚至在意识清醒的患者中，也可能以轻微症状或体征出现。因此，诊断需要高度的怀疑以及对异常实验室值有适当的敏感性。许多损伤可促使横纹肌溶解症和肌红蛋白尿的发生。肌细胞膜的破坏可能源于对膜的直接机械或毒性损伤，或者无法维持跨膜离子梯度（如在缺血或极度劳累时）。本文回顾了横纹肌溶解症的病因、发病机制、临床特征、并发症及治疗，尤其关注重大灾难背景下的挤压伤。
