可卡因相关性急性肌红蛋白尿性肾衰竭。
Cocaine-associated acute myoglobinuric renal failure.
作者信息
Pogue V A, Nurse H M
机构信息
Department of Medicine, Harlem Hospital Center, College of Physicians and Surgeons, New York, New York 10037.
出版信息
Am J Med. 1989 Feb;86(2):183-6. doi: 10.1016/0002-9343(89)90266-0.
PURPOSE
Abuse of cocaine is associated with serious medical complications involving the heart, central nervous system, and gastrointestinal tract. Renal complications appear to be uncommon. We describe herein four patients with rhabdomyolysis and acute myoglobinuric renal failure temporally related to cocaine use.
CASE REPORTS
Acute cocaine intoxication was the most common presentation and rhabdomyolysis was an unexpected finding. Renal failure progressed rapidly in all patients, necessitating dialysis in two. The prognosis was good, and all patients survived. The mechanism of cocaine injury is unclear; possibilities include increased muscle activity, muscle compression, hyperthermia, and vasospasm with muscle ischemia.
CONCLUSION
Rhabdomyolysis with acute renal failure should be recognized as a possible complication of cocaine abuse.
目的
可卡因滥用与涉及心脏、中枢神经系统和胃肠道的严重医学并发症相关。肾脏并发症似乎并不常见。我们在此描述了4例横纹肌溶解症和急性肌红蛋白尿性肾衰竭患者，这些病例在时间上与可卡因使用相关。
病例报告
急性可卡因中毒是最常见的表现，横纹肌溶解症是一个意外发现。所有患者的肾衰竭进展迅速，其中2例需要透析。预后良好，所有患者均存活。可卡因损伤的机制尚不清楚；可能的原因包括肌肉活动增加、肌肉受压、体温过高以及伴有肌肉缺血的血管痉挛。
结论
横纹肌溶解症合并急性肾衰竭应被视为可卡因滥用的一种可能并发症。
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