Wang L M, Tsai S T, Ho L T, Hu S C, Lee C H
Emergency Department, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Diabetes Res Clin Pract. 1994 Dec 31;26(3):209-14. doi: 10.1016/0168-8227(94)90062-0.
Rhabdomyolysis (RM) is a clinical and laboratory syndrome resulting from leakage of muscle cell contents into plasma. The increased plasma concentration of the substances released such as creatine kinase (CK) permits the clinician to diagnose this syndrome. Non-traumatic RM has occasionally been reported in patients with diabetic decompensation. We encountered about 44 cases of RM in 265 diabetic emergencies (including DKA or hyperosmolar, or both) during the period from 1984-1 to 1990-6, diagnosed based on (1) serum creatine kinase (CK) > 1000 IU/l and (2) the absence of acute myocardial infarction, stroke and end-stage renal disease. On admission, those who presented with RM had significantly higher concentration of blood urine nitrogen (BUN) (83.3 +/- 5.9 vs. 58.8 +/- 2.4 mg/dl, P < 0.05), creatine (4.45 +/- 0.4 vs. 2.97 +/- 0.1 mg/dl, P < 0.05) and serum osmolarity (386.5 +/- 5.2 vs. 351.6 +/- 2.4 mOsm/kg, P < 0.05). The mortality within 1 week of diabetic emergencies (38.5% for DKA, 35.5% for HHNK) was higher in patients with RM than those without RM (9.7% for DKA, 26.7% for HHNK). There was a correlation (r = 0.49, P < 0.05) between the levels of serum creatinine and CK in patients with RM.(ABSTRACT TRUNCATED AT 250 WORDS)
横纹肌溶解症（RM）是一种临床和实验室综合征，由肌肉细胞内容物漏入血浆所致。肌酸激酶（CK）等释放物质的血浆浓度升高使临床医生能够诊断该综合征。糖尿病失代偿患者偶尔会报告非创伤性RM。在1984年1月至1990年6月期间，我们在265例糖尿病急症（包括糖尿病酮症酸中毒或高渗性昏迷或两者皆有）中遇到了约44例RM，诊断依据为：（1）血清肌酸激酶（CK）>1000 IU/l；（2）无急性心肌梗死、中风和终末期肾病。入院时，出现RM的患者血尿素氮（BUN）浓度（83.3±5.9 vs. 58.8±2.4 mg/dl，P<0.05）、肌酸（4.45±0.4 vs. 2.97±0.1 mg/dl，P<0.05）和血清渗透压（386.5±5.2 vs. 351.6±2.4 mOsm/kg，P<0.05）显著更高。RM患者糖尿病急症1周内的死亡率（糖尿病酮症酸中毒为38.5%，高渗高血糖非酮症综合征为35.5%）高于无RM的患者（糖尿病酮症酸中毒为9.7%，高渗高血糖非酮症综合征为26.7%）。RM患者血清肌酐水平与CK水平之间存在相关性（r = 0.49，P<0.05）。（摘要截断于250字）
