Clavelou P, Tubert V, Mansoor O, Darcha C, Guélon D
Clinique Neurologique, Hôpital Fontmaure, Chamalières.
Ann Fr Anesth Reanim. 1993;12(3):326-8. doi: 10.1016/s0750-7658(05)80661-6.
A case is reported of a 74-year-old man who developed rhabdomyolysis during treatment for status asthmaticus. This patient had a history of asthma. He was admitted after a cardiac arrest during a severe asthma attack. Continuous muscle relaxation (4 mg.h-1 of pancuronium for 10 days; total dose 960 mg) was required to carry out mechanical ventilation. Bronchodilators and high doses of steroids (300 mg.day-1 of methylprednisolone for 10 days) were also given. After the administration of muscle relaxant had been discontinued, the patient displayed a severe, predominantly proximal, quadriplegia as well as a raised blood creatinine kinase concentration. The urine was brown coloured over a 24 h period. Rhabdomyolysis was confirmed by muscle biopsy. The patient recovered over a period of one month. This case is discussed in the light of some other similar reports in the literature. It seems that the combination of muscle relaxant with high doses of steroids is to be incriminated.
报告了一例74岁男性在哮喘持续状态治疗期间发生横纹肌溶解症的病例。该患者有哮喘病史。他在一次严重哮喘发作期间心脏骤停后入院。为进行机械通气，需要持续肌肉松弛（泮库溴铵4毫克·小时⁻¹，持续10天；总剂量960毫克）。还给予了支气管扩张剂和高剂量类固醇（甲泼尼龙300毫克·天⁻¹，持续10天）。在停用肌肉松弛剂后，患者出现严重的、以近端为主的四肢瘫痪以及血肌酐激酶浓度升高。在24小时内尿液呈褐色。肌肉活检证实为横纹肌溶解症。患者在一个月内康复。结合文献中其他一些类似报告对该病例进行了讨论。似乎肌肉松弛剂与高剂量类固醇的联合使用应被归咎于此。
