O'Connor Francis G, Brennan Fred H, Campbell William, Heled Yuval, Deuster Patricia
Consortium for Health and Military Performance (CHAMP), Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Curr Sports Med Rep. 2008 Nov-Dec;7(6):328-31. doi: 10.1249/JSR.0b013e31818f0317.
Exertional rhabdomyolysis (ER) is a condition characterized by muscle pain, swelling, and weakness following some exertional stress, with or without concomitant heat stress. Athletes who experience ER often present to the emergency department, the training room, or the physician's office seeking guidance and care for this condition, often feeling it is simply normal delayed onset muscle soreness. The astute clinician must perform a thorough history and focused exam, in addition to ordering a serum creatine kinase (CK) and urinalysis. In this clinical setting, a CK equal to or greater than five times normal or a urine dipstick testing positive for blood with no demonstrable red blood cells upon microscopic assessment confirms the diagnosis. A urine or serum myoglobin is more definitive when expeditiously available. After treatment for ER, the provider must risk-stratify the athlete for risk of recurrence, consider further testing, and make the difficult decision on when, if, and under what conditions the athlete can safely return to play.
运动性横纹肌溶解症（ER）是一种在经历某些运动应激后出现肌肉疼痛、肿胀和无力的病症，无论是否伴有热应激。经历ER的运动员常前往急诊科、训练室或医生办公室，寻求针对这种病症的指导和护理，他们常常觉得这只是正常的延迟性肌肉酸痛。除了开具血清肌酸激酶（CK）和尿液分析的检查单外，敏锐的临床医生还必须进行全面的病史询问和重点体格检查。在这种临床情况下，CK等于或大于正常水平的五倍，或者尿液试纸检测呈血尿阳性且显微镜检查未发现明显红细胞，即可确诊。若能迅速获得尿液或血清肌红蛋白检测结果，则诊断更具确定性。在对ER进行治疗后，医疗人员必须对运动员复发风险进行分层，考虑进一步检查，并就是否、何时以及在何种条件下运动员能够安全重返赛场做出艰难决策。
