Cadnapaphornchai P, Taher S, McDonald F D
Am J Med Sci. 1980 Sep-Oct;280(2):66-72. doi: 10.1097/00000441-198009000-00001.
Thirty patients with drug associated acute nontraumatic rhabdomyolysis were evaluated. Acute renal failure, oliguric (ORF) in ten and nonoliguric (NORF) in another ten patients, was observed. The remaining ten patients did not develop renal failure (NRF). To identify factors that may have contributed to this clinical diversity, these three groups were compared. Data from 51 patients reported in the literature were also included in the analysis. The patients with ORF were slightly younger than patients with NORF. They had higher incidence of muscle swelling and higher serum potassium. ORF was more severe, lasted longer, and required more dialysis than NORF. The group of patients with renal failure had higher incidence of coma and more patients with very high muscle enzyme elevation than NRF patients. Hypercalcemia, a unique complication of rhabdomyolysis, was reported in 22 patients. It was not seen in patients without renal failure. There were no differences in age, incidence of coma, muscle swelling, and muscle enzyme between those who did and those who did not develop hypercalcemia. Sixteen patients with nerve entrapment had higher incidence of coma and muscle swelling than the rest of the patients.
对30例药物相关性急性非创伤性横纹肌溶解症患者进行了评估。观察到10例患者出现急性肾衰竭，其中10例为少尿型（ORF），另外10例为非少尿型（NORF）。其余10例患者未发生肾衰竭（NRF）。为了确定可能导致这种临床差异的因素，对这三组患者进行了比较。分析中还纳入了文献报道的51例患者的数据。ORF患者比NORF患者略年轻。他们肌肉肿胀的发生率更高，血清钾水平也更高。与NORF相比，ORF更严重，持续时间更长，需要更多的透析治疗。肾衰竭患者昏迷的发生率更高，肌肉酶升高非常明显的患者比NRF患者更多。22例患者报告有高钙血症，这是横纹肌溶解症的一种独特并发症，在无肾衰竭的患者中未观察到。发生高钙血症的患者与未发生高钙血症的患者在年龄、昏迷发生率、肌肉肿胀和肌肉酶方面没有差异。16例神经受压患者昏迷和肌肉肿胀的发生率高于其他患者。
