横纹肌溶解症：发病机制、诊断与治疗
Rhabdomyolysis: pathogenesis, diagnosis, and treatment.
作者信息
Torres Patrick A, Helmstetter John A, Kaye Adam M, Kaye Alan David
机构信息
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA.
出版信息
Ochsner J. 2015 Spring;15(1):58-69.
Abstract
BACKGROUND
Rhabdomyolysis is a complex medical condition involving the rapid dissolution of damaged or injured skeletal muscle.
METHODS
This review focuses on the epidemiology, pathophysiology, causes, presentation, diagnosis, complications, management, and anesthetic considerations related to rhabdomyolysis.
RESULTS
Any form of muscle damage--and by extension any entity that causes muscle damage--can initiate rhabdomyolysis. One of the most important treatment goals when rhabdomyolysis is suspected is avoiding acute kidney injury.
CONCLUSION
All clinicians should be aware of common causes, diagnosis, and treatment options.
摘要
背景
横纹肌溶解症是一种复杂的医学病症，涉及受损或受伤骨骼肌的快速溶解。
方法
本综述聚焦于与横纹肌溶解症相关的流行病学、病理生理学、病因、临床表现、诊断、并发症、治疗及麻醉注意事项。
结果
任何形式的肌肉损伤——进而任何导致肌肉损伤的因素——都可引发横纹肌溶解症。怀疑发生横纹肌溶解症时，最重要的治疗目标之一是避免急性肾损伤。
结论
所有临床医生都应了解其常见病因、诊断方法及治疗选择。
相似文献
1
Rhabdomyolysis: pathogenesis, diagnosis, and treatment.横纹肌溶解症：发病机制、诊断与治疗
Ochsner J. 2015 Spring;15(1):58-69.
2
Macrophage extracellular trap formation promoted by platelet activation is a key mediator of rhabdomyolysis-induced acute kidney injury.血小板激活促进的巨噬细胞细胞外陷阱形成是横纹肌溶解症诱导的急性肾损伤的关键介质。
Nat Med. 2018 Feb;24(2):232-238. doi: 10.1038/nm.4462. Epub 2018 Jan 8.
3
Rhabdomyolysis.横纹肌溶解症。
Chest. 2013 Sep;144(3):1058-1065. doi: 10.1378/chest.12-2016.
4
[Rhabdomyolysis: have you considered food poisoning from quails?].[横纹肌溶解症：你考虑过鹌鹑引起的食物中毒吗？]
G Ital Nefrol. 2020 Apr 9;37(2):2020-vol2.
5
Non-traumatic rhabdomyolysis: Background, laboratory features, and acute clinical management.非创伤性横纹肌溶解症：背景、实验室检查特征及急性临床处理
Clin Biochem. 2017 Aug;50(12):656-662. doi: 10.1016/j.clinbiochem.2017.02.016. Epub 2017 Feb 21.
6
The other medical causes of rhabdomyolysis.横纹肌溶解症的其他医学病因。
Am J Med Sci. 2003 Aug;326(2):79-88. doi: 10.1097/00000441-200308000-00005.
7
Drugs and Rhabdomyolysis: From Liver to Kidney.药物与横纹肌溶解：从肝脏到肾脏
Curr Vasc Pharmacol. 2015;13(6):725-37. doi: 10.2174/1570161113666150130151839.
8
Rhabdomyolysis-Induced Acute Kidney Injury in Diabetic Emergency: Underdiagnosed and an Important Association to Be Aware of.糖尿病急症中横纹肌溶解所致急性肾损伤：诊断不足且需警惕的重要关联。
Case Rep Med. 2018 Oct 31;2018:4132738. doi: 10.1155/2018/4132738. eCollection 2018.
9
From quail to earthquakes and human conflict: a historical perspective of rhabdomyolysis.从鹌鹑到地震与人类冲突：横纹肌溶解症的历史视角
Clin Kidney J. 2020 May 22;14(4):1088-1096. doi: 10.1093/ckj/sfaa075. eCollection 2021 Apr.
10
Pediatric Rhabdomyolysis.小儿横纹肌溶解症
Pediatr Rev. 2020 Jun;41(6):265-275. doi: 10.1542/pir.2018-0300.
引用本文的文献
1
Crush Syndrome and Systemic Necrosis in Trauma Patients: A Systematic Review of Pathophysiology, Anatomical Impact, and Renal Outcomes.创伤患者的挤压综合征与全身坏死：病理生理学、解剖学影响及肾脏结局的系统评价
Cureus. 2025 Aug 7;17(8):e89592. doi: 10.7759/cureus.89592. eCollection 2025 Aug.
2
Increased risk of rhabdomyolysis in patients using statins: a population-based case-control study.使用他汀类药物的患者发生横纹肌溶解症的风险增加：一项基于人群的病例对照研究。
Ther Adv Drug Saf. 2025 Aug 11;16:20420986251365746. doi: 10.1177/20420986251365746. eCollection 2025.
3
Exertional Rhabdomyolysis and Ultra-Trail Races: A Systematic Review Highlighting the Significant Impact of Eccentric Load.运动性横纹肌溶解症与超长距离越野赛：一项强调离心负荷重大影响的系统评价
Muscles. 2024 Aug 13;3(3):242-258. doi: 10.3390/muscles3030022.
4
Impact of Rhabdomyolysis on Clinical Outcomes in Patients With Acute Myocardial Infarction.横纹肌溶解对急性心肌梗死患者临床结局的影响。
Cureus. 2025 Jul 1;17(7):e87142. doi: 10.7759/cureus.87142. eCollection 2025 Jul.
5
Acute Rhabdomyolysis as a Rare Manifestation of Hypothyroidism: A Case Report and Literature Review.急性横纹肌溶解症作为甲状腺功能减退症的罕见表现：一例报告及文献综述
Cureus. 2025 Jun 24;17(6):e86675. doi: 10.7759/cureus.86675. eCollection 2025 Jun.
6
Serum Concentrations of Imidazole Dipeptides and Serum Amyloid A in a Bottlenose Dolphin () with Rhabdomyolysis: Potential Biomarkers for Muscular Damage.患有横纹肌溶解症的宽吻海豚（）血清中咪唑二肽和血清淀粉样蛋白A的浓度：肌肉损伤的潜在生物标志物
Animals (Basel). 2025 Jul 2;15(13):1950. doi: 10.3390/ani15131950.
7
Severe rhabdomyolysis induced by bezafibrate in the treatment of severe acute pancreatitis with hyperlipidemia: A case report.苯扎贝特治疗重症急性胰腺炎合并高脂血症致严重横纹肌溶解症1例报告
Medicine (Baltimore). 2025 Jun 27;104(26):e43009. doi: 10.1097/MD.0000000000043009.
8
Time-to-Onset Analysis of Rhabdomyolysis Associated With Selective Serotonin and Serotonin-Noradrenaline Reuptake Inhibitors Using the Japanese Pharmacovigilance Database.利用日本药物警戒数据库对与选择性5-羟色胺及5-羟色胺-去甲肾上腺素再摄取抑制剂相关的横纹肌溶解症进行发病时间分析。
In Vivo. 2025 Jul-Aug;39(4):2115-2122. doi: 10.21873/invivo.14007.
9
Dermatomyositis, Rhabdomyolysis, and Statin-Induced Myopathy: A Case Report Illustrating the Spectrum of Myopathy.皮肌炎、横纹肌溶解症与他汀类药物所致肌病：一则说明肌病谱的病例报告
Cureus. 2025 May 26;17(5):e84854. doi: 10.7759/cureus.84854. eCollection 2025 May.
10
The Hidden Hazard of Hypothyroidism: Statin-Associated Rhabdomyolysis With Life-Threatening Complications.甲状腺功能减退症的隐匿危害：他汀类药物相关横纹肌溶解症及危及生命的并发症
Cureus. 2025 Jun 7;17(6):e85506. doi: 10.7759/cureus.85506. eCollection 2025 Jun.
本文引用的文献
1
Anesthesia and Duchenne or Becker muscular dystrophy: review of 117 anesthetic exposures.麻醉与杜氏或贝克型肌营养不良症：117例麻醉暴露的回顾
Paediatr Anaesth. 2013 Sep;23(9):855-64. doi: 10.1111/pan.12248. Epub 2013 Aug 6.
2
Cytochrome P450 drug interactions with statin therapy.细胞色素 P450 药物相互作用与他汀类药物治疗。
Singapore Med J. 2013 Mar;54(3):131-5. doi: 10.11622/smedj.2013044.
3
The controversies of statin therapy: weighing the evidence.他汀类药物治疗的争议：权衡证据。
J Am Coll Cardiol. 2012 Sep 4;60(10):875-81. doi: 10.1016/j.jacc.2012.07.007. Epub 2012 Aug 15.
4
Anaesthetic management in patients with Duchenne muscular dystrophy undergoing orthopaedic surgery: a review of 232 cases.杜氏肌营养不良症患者行骨科手术的麻醉管理：232 例回顾性研究
Eur J Anaesthesiol. 2012 Oct;29(10):489-94. doi: 10.1097/EJA.0b013e3283566789.
5
Exertional rhabdomyolysis: a clinical review with a focus on genetic influences.运动性横纹肌溶解症：一项聚焦遗传影响的临床综述
J Clin Neuromuscul Dis. 2012 Mar;13(3):122-36. doi: 10.1097/CND.0b013e31822721ca.
6
Clinical importance of the drug interaction between statins and CYP3A4 inhibitors: a retrospective cohort study in The Health Improvement Network.他汀类药物与 CYP3A4 抑制剂相互作用的临床重要性：在健康改善网络中的回顾性队列研究。
Pharmacoepidemiol Drug Saf. 2012 May;21(5):494-506. doi: 10.1002/pds.3199. Epub 2012 Mar 16.
7
Statin-induced myopathies.他汀类药物引起的肌病。
Pharmacol Rep. 2011;63(4):859-66. doi: 10.1016/s1734-1140(11)70601-6.
8
Statin myopathy: a common dilemma not reflected in clinical trials.他汀类药物相关性肌病：临床试验未反映的常见难题。
Cleve Clin J Med. 2011 Jun;78(6):393-403. doi: 10.3949/ccjm.78a.10073.
9
Early fluid resuscitation in patients with rhabdomyolysis.横纹肌溶解症患者的早期液体复苏。
Nat Rev Nephrol. 2011 May 17;7(7):416-22. doi: 10.1038/nrneph.2011.56.
10
Rhabdomyolysis: pathogenesis of renal injury and management.横纹肌溶解症：肾损伤的发病机制与管理
Pediatr Nephrol. 2011 Oct;26(10):1781-8. doi: 10.1007/s00467-010-1727-3. Epub 2011 Jan 20.
Zotero 插件