Giannoglou George D, Chatzizisis Yiannis S, Misirli Gesthimani
AHEPA University Hospital, Aristotle University Medical School, 1 St. Kiriakidi Street, 54636, Thessaloniki, Greece.
Eur J Intern Med. 2007 Mar;18(2):90-100. doi: 10.1016/j.ejim.2006.09.020.
Rhabdomyolysis is defined as a pathological condition of skeletal muscle cell damage leading to the release of toxic intracellular material into the blood circulation. Its major causes include trauma, ischemia, drugs, toxins, metabolic disorders, and infections. The pathophysiological hallmark of the syndrome is an increase in intracellular free ionized calcium due to either cellular energy depletion, or direct plasma membrane rupture. The increased intracellular calcium activates several proteases, intensifies skeletal muscle cell contractility, induces mitochondrial dysfunction, and increases the production of reactive oxygen species, ultimately resulting in skeletal muscle cell death. Clinically, the syndrome presents with severe muscular pain, weakness and myoglobinuria. Increased myoglobin and creatine phosphokinase as a consequence of muscular cell death are the major laboratory findings, which, in combination with the clinical presentation, lead the clinician to the final diagnosis of the syndrome.
横纹肌溶解症被定义为骨骼肌细胞损伤的一种病理状态，会导致有毒的细胞内物质释放到血液循环中。其主要原因包括创伤、缺血、药物、毒素、代谢紊乱和感染。该综合征的病理生理特征是由于细胞能量耗竭或直接的细胞膜破裂导致细胞内游离离子钙增加。细胞内钙增加会激活多种蛋白酶，增强骨骼肌细胞收缩力，诱导线粒体功能障碍，并增加活性氧的产生，最终导致骨骼肌细胞死亡。临床上，该综合征表现为严重的肌肉疼痛、无力和肌红蛋白尿。肌肉细胞死亡导致的肌红蛋白和肌酸磷酸激酶升高是主要的实验室检查结果，结合临床表现可使临床医生做出该综合征的最终诊断。
