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严重急性呼吸综合征患者中与急性肾衰竭相关的横纹肌溶解症。

Rhabdomyolysis associated with acute renal failure in patients with severe acute respiratory syndrome.

作者信息

Chen L-L, Hsu C-W, Tian Y-C, Fang J-T

机构信息

Division of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.

出版信息

Int J Clin Pract. 2005 Oct;59(10):1162-6. doi: 10.1111/j.1368-5031.2005.00540.x.

Abstract

An outbreak of severe acute respiratory syndrome (SARS) occurred in Taiwan in 2003. SARS complicated with rhabdomyolysis has rarely been reported. This study reported three cases of rhabdomyolysis developing during the clinical course of SARS. Thirty probable SARS patients were admitted to the isolation wards at Linkou Chang Gung Memorial Hospital between 4 April and 4 June 2003. Thirty patients, including four men and 26 women aged from 12 to 87 years (mean age 40). Eleven (36.7%) patients had respiratory failure and required mechanical ventilation with paralytic therapy; three (10%) patients had rhabdomyolysis complicated with acute renal failure and one received haemodialysis; four (13.3%) patients died. Three cases with rhabdomyolysis all received sedative and paralytic therapy for mechanical ventilation. Haemodialysis was performed on one patient. Two patients died from multiple organ failure, and one patient fully recovered from rhabdomyolysis with acute renal failure. SARS is a serious respiratory illness, and its aetiology is a novel coronavirus. Rhabdomyolysis resulting from SARS virus infection was strongly suspected. Immobilisation under paralytic therapy and steroids may also be important in developing rhabdomyolysis.

摘要

2003年台湾地区爆发了严重急性呼吸综合征(SARS)。SARS并发横纹肌溶解症的报道极为罕见。本研究报告了3例在SARS临床病程中发生横纹肌溶解症的病例。2003年4月4日至6月4日期间,30例疑似SARS患者被收治入林口长庚纪念医院隔离病房。这30例患者中,包括4名男性和26名女性,年龄在12至87岁之间(平均年龄40岁)。11例(36.7%)患者出现呼吸衰竭,需要接受机械通气及麻痹治疗;3例(10%)患者发生横纹肌溶解症并并发急性肾衰竭,其中1例接受了血液透析;4例(13.3%)患者死亡。3例横纹肌溶解症患者均接受了用于机械通气的镇静和麻痹治疗。1例患者接受了血液透析。2例患者死于多器官功能衰竭,1例横纹肌溶解症并发急性肾衰竭的患者完全康复。SARS是一种严重的呼吸系统疾病,其病原是一种新型冠状病毒。强烈怀疑横纹肌溶解症是由SARS病毒感染所致。麻痹治疗及类固醇药物导致的制动在横纹肌溶解症的发生中可能也起重要作用。

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