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非创伤性横纹肌溶解所致急性肾衰竭。11例(作者译)

[Acute renal failure due to non traumatic rhabdomyolysis. 11 cases (author's transl)].

作者信息

Brun-Buisson C, George C, Le Gall J R, Regnier B, Carlet J, Rapin M

出版信息

Presse Med (1893). 1979 Dec 10;8(48):3957-60.

PMID:530946
Abstract

Previous nuclear disease was found twice: Mc Ardle disease, dermatomyositis. Causative factors were: strenous exercise, hyperthermia, intoxication, influenza. Myalgias and/or myoedema was recorded in ten cases, associated with an hypovolemia of variable severity in eight. Oligo-anuria was observed in eight cases. The acute renal failure (ARF) was characterized by an increase in the serum creatinin more important than the rise in the blood urea and, in some cases, severe metabolic disturbances: hyperkaliema (6 cases), hypocalcemia (5 cases), hyperphosphatemia (5 cases) and hyperuricemia (5 cases). Diagnosis was made by the increase in sera of the muscles enzymes, specially the CPK and the search for myoglobinuria, positive during the first seven days. A complete recovery of renal function was observed in the nine survivors with a transient and moderate hypercalcemia in three. Three patients had persistant neuro-muscular deficiencies. Non traumatic rhabdomyolysis is not a rare cause of ARF and should be considered when the etiology of ARF is uncertain.

摘要

既往发现过两次核疾病

麦卡德尔病、皮肌炎。致病因素有:剧烈运动、高热、中毒、流感。10例记录有肌痛和/或肌水肿,其中8例伴有不同程度的血容量不足。8例观察到少尿-无尿。急性肾衰竭(ARF)的特征是血清肌酐升高比血尿素升高更明显,在某些情况下还伴有严重的代谢紊乱:高钾血症(6例)、低钙血症(5例)、高磷血症(5例)和高尿酸血症(5例)。通过肌肉酶血清水平升高进行诊断,特别是肌酸磷酸激酶(CPK),并检查肌红蛋白尿,在前七天呈阳性。9名幸存者肾功能完全恢复,其中3例有短暂性和中度高钙血症。3例患者有持续性神经肌肉缺陷。非创伤性横纹肌溶解症是ARF的常见病因,当ARF病因不明时应予以考虑。

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