Mousavi Seyed Reza, Vahabzadeh Maryam, Mahdizadeh Adeleh, Vafaee Mansooreh, Sadeghi Mahmood, Afshari Reza, Balali-Mood Mahdi
Department of Clinical Toxicology and Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Res Med Sci. 2015 Mar;20(3):239-43.
Rhabdomyolysis is a clinical and biochemical syndrome, which is observed in some patients with acute chemical and/or pharmaceutical poisonings. We aimed to investigate rhabdomyolysis in patients with acute poisonings due to different chemicals, natural toxins or drug overdose.
Following approval of the University medical research committee and obtaining informed consents from the patients or their relatives, all patients with acute poisonings who were treated between March 2009 and February 2010 in the Toxicologic Ward of Imam Reza Hospital and had serum creatine phosphokinase (CPK) above 975 IU/L (as a definition for rhabdomyolysis) were studied.
Of 3555 hospitalized poisoned patients, 114 patients had rhabdomyolysis with CPK of 5996 ± 892 IU/L (mean ± standard error). The most common intoxication to induce the rhabdomyolysis was opioid overdose (28%). Acute renal failure (ARF) was diagnosed in 11 (8.7%) patients. There was a linear correlation between CPK and creatinine (P < 0.001), which in turn had a significant correlation with death (P < 0.05).
Patients with acute poisoning were at risk of rhabdomyolysis. Acute opioid poisoning was the most common cause of toxic rhabdomyolysis in the intoxicated patients, and ARF was the main complication.
横纹肌溶解症是一种临床和生化综合征，在一些急性化学和/或药物中毒患者中可见。我们旨在调查因不同化学物质、天然毒素或药物过量导致急性中毒患者的横纹肌溶解症情况。
经大学医学研究委员会批准并获得患者或其亲属的知情同意后，对2009年3月至2010年2月在伊玛目礼萨医院毒理学病房接受治疗且血清肌酸磷酸激酶（CPK）高于975 IU/L（作为横纹肌溶解症的定义）的所有急性中毒患者进行研究。
在3555例住院中毒患者中，114例患者出现横纹肌溶解症，CPK为5996±892 IU/L（均值±标准误）。导致横纹肌溶解症最常见的中毒类型是阿片类药物过量（28%）。11例（8.7%）患者被诊断为急性肾衰竭（ARF）。CPK与肌酐之间存在线性相关性（P<0.001），而肌酐又与死亡有显著相关性（P<0.05）。
急性中毒患者有发生横纹肌溶解症的风险。急性阿片类中毒是中毒患者中毒性横纹肌溶解症最常见的原因，急性肾衰竭是主要并发症。
