Kuzmanovska Biljana, Cvetkovska Emilija, Kuzmanovski Igor, Jankulovski Nikola, Shosholcheva Mirjana, Kartalov Andrijan, Spirovska Tatjana
Universty Clinic for Anesthesiology, Reanimation and Intensive Care Medicine, Clinical Campus "Mother Teresa", Skopje, Macedonia.
University Clinic for Neurology, Clinical Campus "Mother Teresa", Skopje, Macedonia.
Med Arch. 2016 Jul 27;70(4):308-310. doi: 10.5455/medarh.2016.70.308-310.
Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication.
of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians.
A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1 till December 31 2015 was performed. Patients medical records were screened for available serum creatine kinase (CK) with levels > 200 U/l, presence of myoglobin in the serum in levels > 80 ng/ml, or if they had a clinical diagnosis of rhabdomyolysis by an attending doctor. Descriptive statistical methods were used to analyze the collected data.
Out of totally 1084 patients hospitalized in the ICU, 93 were diagnosed with rhabdomyolysis during the course of one year. 82(88%) patients were trauma patients, while 11(12%) were surgical non trauma patients. 7(7.5%) patients diagnosed with rhabdomyolysis developed acute kidney injury (AKI) that required dialysis. Average values of serum myoglobin levels were 230 ng/ml, with highest values of > 5000 ng/ml. Patients who developed AKI had serum myoglobin levels above 2000 ng/ml. Average values of serum CK levels were 400 U/l, with highest value of 21600 U/l. Patients who developed AKI had serum CK levels above 3000 U/l.
Regular monitoring and early detection of elevated serum CK and myoglobin levels in critically ill surgical and trauma patients is recommended in order to recognize and treat rhabdomyolysis in timely manner and thus prevent development of AKI.
横纹肌溶解症是一种骨骼肌损伤综合征，伴有肌红蛋白尿、肌肉无力、电解质失衡，且常伴有严重并发症急性肾损伤。
是检测外科重症监护病房（ICU）中重症患者横纹肌溶解症的发病率，并提高临床医生对这种疾病及其治疗的认识。
对2015年1月1日至12月31日在马其顿斯科普里“特蕾莎修女”大学外科诊所外科ICU收治的所有外科和创伤患者进行回顾性研究。筛查患者病历，查看血清肌酸激酶（CK）水平>200 U/l、血清肌红蛋白水平>80 ng/ml，或主治医生临床诊断为横纹肌溶解症的情况。采用描述性统计方法分析收集的数据。
在ICU住院的1084例患者中，有93例在一年内被诊断为横纹肌溶解症。82例（88%）患者为创伤患者，11例（12%）为非创伤性外科患者。7例（7.5%）诊断为横纹肌溶解症的患者发生了需要透析的急性肾损伤（AKI）。血清肌红蛋白水平的平均值为230 ng/ml，最高值>5000 ng/ml。发生AKI的患者血清肌红蛋白水平高于2000 ng/ml。血清CK水平的平均值为400 U/l，最高值为21600 U/l。发生AKI的患者血清CK水平高于3000 U/l。
建议对重症外科和创伤患者定期监测并早期发现血清CK和肌红蛋白水平升高，以便及时识别和治疗横纹肌溶解症，从而预防AKI的发生。
