Division of Neuroanesthesia and Neurocritical Care, Department of Anesthesia, Intensive Care and Perioperative Medicine, University of Brescia at Spedali Civili, Brescia, Italy.
Curr Opin Rheumatol. 2012 Nov;24(6):616-22. doi: 10.1097/BOR.0b013e3283588d2f.
To describe the incidence, major risk factors, and the clinical, electrophysiological, and histological features of critical illness myopathy (CIM). Major pathogenetic mechanisms and long-term consequences of CIM are also reviewed.
CIM is frequently associated with critical illness polyneuropathy (CIP), and may have a relevant impact on patients' outcome. CIM has an earlier onset than CIP, and recovery is faster. Loss of myosin filaments on muscle biopsy is important to diagnose CIM, and has a good prognosis. Critical illness, use of steroids, and immobility concur in causing CIM.
A rationale diagnostic approach to CIM using clinical, electrophysiological, and muscle biopsy investigations is important to plan adequate therapy and to predict recovery.
描述危重病性肌病(CIM)的发病率、主要危险因素,以及其临床、电生理和组织学特征。本文还回顾了 CIM 的主要发病机制和长期后果。
CIM 常与危重病性多发性神经病(CIP)相关,可能对患者的预后有重要影响。CIM 的发病早于 CIP,且恢复更快。肌肉活检中肌球蛋白丝的丢失对于诊断 CIM 很重要,且具有良好的预后。危重病、使用类固醇和长期卧床都会导致 CIM。
使用临床、电生理和肌肉活检检查对 CIM 进行合理的诊断方法对于计划适当的治疗和预测恢复很重要。