Kleinknecht D, Parent A, Blot P, Bochereau G, Lallement P Y, Pourriat J L
Ann Med Interne (Paris). 1982;133(8):549-52.
Seven episodes of rhabdomyolysis with acute renal failure (ARF) have been observed in 6 patients treated with various short-acting tranquilizers and antidepressants. Clinical features usually included severe hyperthermia, diffuse hypertonicity with or without coma, circulatory failure or unstable blood pressure, and often acute respiratory failure. Serum CPK were always elevated. The type of ARF was prerenal failure without oliguria in 5/7 episodes, and acute tubular necrosis in 2/7 episodes, requiring hemodialyses in one patient. Three patients died. In any case, the tranquilizers and antidepressants responsible for this syndrome were stopped, and electrolyte disorders and acidosis were corrected. Associated acute circulatory failure, septicemia and/or acute hepatic failure required prompt therapy, and artificial ventilation was required in 4 instances. The further use of phenothiazines, butyrophenones, sulpiride and their derivatives should be avoided in any patient having developed such an accident, whose pathophysiology is similar to that described in malignant hyperthermia of various origin.
在6例接受各种短效镇静剂和抗抑郁药治疗的患者中，观察到7例横纹肌溶解合并急性肾衰竭（ARF）。临床特征通常包括严重高热、伴有或不伴有昏迷的弥漫性高张力、循环衰竭或血压不稳定，且常伴有急性呼吸衰竭。血清肌酸磷酸激酶（CPK）总是升高。ARF的类型在7例中有5例为肾前性肾衰竭且无少尿，2例为急性肾小管坏死，其中1例患者需要进行血液透析。3例患者死亡。在任何情况下，停用导致该综合征的镇静剂和抗抑郁药，并纠正电解质紊乱和酸中毒。合并的急性循环衰竭、败血症和/或急性肝衰竭需要及时治疗，4例患者需要进行人工通气。对于发生过此类意外的任何患者，应避免进一步使用吩噻嗪类、丁酰苯类、舒必利及其衍生物，其病理生理与各种原因引起的恶性高热相似。
