Veenstra J, Smit W M, Krediet R T, Arisz L
Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Nephrol Dial Transplant. 1994;9(6):637-41. doi: 10.1093/ndt/9.6.637.
The incidence, causes and complications of severe rhabdomyolysis (creatine phosphokinase (CK) > or = 5000 U/l) were studied during a 7-year study period in a large university hospital population. This condition was present in 0.074% of all admitted patients. The mortality in the study group (n = 93) was 32% and the incidence of acute renal failure (ARF) 51%. Ischaemia was the most frequent cause, and drugs, alcohol and/or coma were the second most common cause of severe rhabdomyolysis. Patients with rhabdomyolysis due to ischaemia were older, had ARF more often, and also had the highest mortality. Hyperkalaemia (potassium > or = 5.5 mmol/l) occurred in 13% of the patients, and all of them had or developed an impaired renal function. Hypocalcaemia (calcium < or = 2.00 mmol/l) was found in 41%. The incidence of ARF and electrolyte disturbances was higher in patients with CK levels exceeding 15,000 U/l. Mortality was significantly higher in patients with ARF. Plasma concentrations of potassium and calcium correlated better with the severity of renal failure than with the maximal height of plasma CK.
在一所大型大学医院的人群中，进行了为期7年的研究，以探讨严重横纹肌溶解症（肌酸磷酸激酶（CK）≥5000 U/L）的发病率、病因及并发症。在所有入院患者中，这种情况的发生率为0.074%。研究组（n = 93）的死亡率为32%，急性肾衰竭（ARF）的发生率为51%。缺血是最常见的病因，药物、酒精和/或昏迷是严重横纹肌溶解症的第二大常见病因。因缺血导致横纹肌溶解症的患者年龄较大，ARF的发生率更高，死亡率也最高。13%的患者发生高钾血症（血钾≥5.5 mmol/L），且所有患者均有或出现肾功能损害。41%的患者存在低钙血症（血钙≤2.00 mmol/L）。CK水平超过15,000 U/L的患者中，ARF和电解质紊乱的发生率更高。ARF患者的死亡率显著更高。血钾和血钙的血浆浓度与肾衰竭严重程度的相关性，优于与血浆CK最高值的相关性。
