Chang C Y, Fang J T, Huang C C
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Changgeng Yi Xue Za Zhi. 1996 Mar;19(1):10-5.
Thirty-one patients (26 males, 5 females) with mean age 35 +/- 19 years (range 8 to 85 years) were diagnosed as non-traumatic rhabdomyolysis by clinical findings and elevation of serum creatine kinase (CK) between January 1989 and December 1993. Causes, laboratory measures, clinical courses, and outcome were reviewed retrospectively. Drug abuse, seizure, and excessive activity are the most common etiologies for non-traumatic rhabdomyolysis. Twelve patients presented with muscular pain and seven patients with muscle weakness. Twenty eight patients had urinalysis and five of them (18%) had negative orthotolidine dipstick test. Only seven patients (25%) were detected positive orthotolidine test without microscopic hematuria. Patients with acute renal failure had higher levels of potassium and uric acid. The patients who developed acute renal failure after admission had significantly higher levels of uric acid. The peak levels of CK did not correlate with development of acute renal failure. There was no episode of hyercalcemia. Seventeen patients (55%) had acute renal failure. Hemodialysis was required in nine cases. All survivors recovered with normal renal function except one who needed maintenance hemodialysis after two months follow-up. Two patients died of multi-organ failure and sepsis.
1989年1月至1993年12月期间，31例患者（26例男性，5例女性），平均年龄35±19岁（范围8至85岁），根据临床表现及血清肌酸激酶（CK）升高被诊断为非创伤性横纹肌溶解症。对病因、实验室检查、临床病程及转归进行回顾性分析。药物滥用、癫痫发作及过度活动是非创伤性横纹肌溶解症最常见的病因。12例患者出现肌肉疼痛，7例患者出现肌无力。28例患者进行了尿液分析，其中5例（18%）邻联甲苯胺试纸试验阴性。仅7例患者（25%）邻联甲苯胺试验阳性但无镜下血尿。急性肾衰竭患者血钾及尿酸水平较高。入院后发生急性肾衰竭的患者尿酸水平显著更高。CK峰值水平与急性肾衰竭的发生无关。未出现高钙血症。17例患者（55%）发生急性肾衰竭。9例需要血液透析。除1例在随访2个月后需要维持性血液透析外，所有幸存者肾功能均恢复正常。2例患者死于多器官功能衰竭及脓毒症。
