Kárpáti I, Kurta G, Mátyas J, Ujhelyi L, Kakuk G
Debreceni Orvostudományi Egyetem, I. sz. Belgyógyászati Klinika.
Orv Hetil. 1990 May 27;131(21):1147-50.
Authors report a case of rhabdomyolysis occurring in a chronic alcoholic patient where they suspect in the development of rhabdomyolysis beside the effect of alcohol also a role of drug intoxication and muscle compression. They found sustained myoglobinaemia and myoglobinuria, while in this case beside the hypocalcemia during the initial phase of rhabdomyolysis normal parathyroid hormone level was found. Therefore in alcoholic intoxicated patients the measurement of creatine kinase is indicated. Beside total lactate dehydrogenase the determination of isoenzymes is in some cases helpful. In the presented case despite extensive rhabdomyolysis, acute renal failure was prevented by early volumen replacement therapy and use mannitol-sodium bicarbonate infusions. Authors discuss the possibility of the role of calcium blocking agent nifedipine in the prevention of rhabdomyolysis and acute renal failure.
作者报告了一例慢性酒精中毒患者发生横纹肌溶解症的病例,他们怀疑在横纹肌溶解症的发生过程中,除了酒精的作用外,药物中毒和肌肉受压也起到了作用。他们发现患者存在持续性肌红蛋白血症和肌红蛋白尿,而在该病例中,除了横纹肌溶解症初始阶段出现的低钙血症外,甲状旁腺激素水平正常。因此,对于酒精中毒患者,建议检测肌酸激酶。除了总乳酸脱氢酶外,在某些情况下测定同工酶也有帮助。在本病例中,尽管横纹肌溶解症严重,但通过早期容量替代治疗和使用甘露醇 - 碳酸氢钠输注,预防了急性肾衰竭。作者讨论了钙通道阻滞剂硝苯地平在预防横纹肌溶解症和急性肾衰竭中发挥作用的可能性。