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[横纹肌溶解症。449例患者的描述性研究]

[Rhabdomyolysis. A descriptive study of 449 patients].

作者信息

Herráez García Jacinto, Torracchi Carrasco Aldo Mateo, Antolí-Royo Ana Cristina, de la Fuente Blanco Rebeca, Santos Jiménez Maria Teresa

机构信息

Servicio de Medicina Interna I, Hospital Universitario de Salamanca, Salamanca, España.

出版信息

Med Clin (Barc). 2012 Sep 8;139(6):238-42. doi: 10.1016/j.medcli.2011.05.021. Epub 2011 Sep 21.

DOI:10.1016/j.medcli.2011.05.021
PMID:21939988
Abstract

BACKGROUND AND OBJECTIVES

Rhabdomyolysis is a clinical syndrome characterized by acute necrosis of skeletal muscles along with the release of breakdown products into the bloodstream. Rhabdomyolysis is potentially lethal and its most serious complication is acute renal failure (ARF). Diagnosis is established by the 5-times elevation (975 UI/l) over the upper limit of creatine-kinase (CK).

PATIENTS AND METHODS

We performed a retrospective study on Salamanca University Hospital for the period 1999-2010. There were 449 patients diagnosed with rhabdomyolysis over which we tested demographic, etiologic, analytic, complication and mortality variables.

RESULTS

Out of 449 patients, 69% were male. Average age was 66.5 ± 21 years. Most frequent etiologies were trauma, sepsis and immobility/crushing (24, 19 and 17% respectively). Maximum levels of CK were 343,170 ng/ml and its increase did not show significant association with mortality or ARF. This was found in 54% of patients (mean creatinine 3.03 mg/dl) and it was significantly associated with mortality (P <. 001). Global mortality was 18.7%. There were no significant associations between mortality and unique or multiple causes. However, there were significant associations between mortality and age (P <. 001) and 90% of deaths occurred among patients over 60 years old.

CONCLUSION

Rhabdomyolysis prevails in elder males. Trauma, sepsis and immobility/crushing are the most frequent etiologies. CK values are not related with ARF or mortality. Mortality is associated with most frequent causes, old age and ARF.

摘要

背景与目的

横纹肌溶解症是一种临床综合征,其特征为骨骼肌急性坏死,同时分解产物释放至血液中。横纹肌溶解症有潜在致死性,其最严重的并发症是急性肾衰竭(ARF)。通过肌酸激酶(CK)超过上限5倍(975 UI/l)来确诊。

患者与方法

我们对萨拉曼卡大学医院1999年至2010年期间进行了一项回顾性研究。有449例被诊断为横纹肌溶解症的患者,我们对其人口统计学、病因学、分析、并发症及死亡率变量进行了检测。

结果

449例患者中,69%为男性。平均年龄为66.5±21岁。最常见的病因是创伤、脓毒症和制动/挤压伤(分别为24%、19%和17%)。CK的最高水平为343,170 ng/ml,其升高与死亡率或急性肾衰竭无显著关联。54%的患者出现急性肾衰竭(平均肌酐3.03 mg/dl),且与死亡率显著相关(P<.001)。总体死亡率为18.7%。死亡率与单一或多种病因之间无显著关联。然而,死亡率与年龄之间存在显著关联(P<.001),90%的死亡发生在60岁以上的患者中。

结论

横纹肌溶解症在老年男性中更为常见。创伤、脓毒症和制动/挤压伤是最常见的病因。CK值与急性肾衰竭或死亡率无关。死亡率与最常见病因、老年及急性肾衰竭相关。

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