Horowitz B Z, Panacek E A, Jouriles N J
Emergency Medicine and Clinical Toxicology, University of California, Davis Medical Center, Sacramento, USA.
J Emerg Med. 1997 Nov-Dec;15(6):833-7. doi: 10.1016/s0736-4679(97)00193-5.
A case of acute renal failure due to rhabdomyolysis in a patient who used cocaine on a daily basis is presented. In contrast to many prior reports of renal failure occurring with cocaine-associated rhabdomyolysis, our patient did not use intravenous cocaine and did not have any evidence of trauma, seizure, hypotension, hyperthermia, hyperactivity, or coma. His creatine phosphokinase peaked at 448,000 U/liter. He was treated initially with forced diuresis and i.v. furosemide, but he became oliguric, developed pulmonary edema, and required hemodialysis. He recovered fully after 3 weeks of dialysis. The literature is reviewed in an attempt to delineate a rational approach to evaluating cocaine users at risk for rhabdomyolysis.
本文介绍了一例因横纹肌溶解导致急性肾衰竭的病例，该患者有每日使用可卡因的习惯。与许多先前关于可卡因相关横纹肌溶解导致肾衰竭的报道不同，我们的患者未使用静脉注射可卡因，也没有任何创伤、癫痫、低血压、高热、多动或昏迷的迹象。他的肌酸磷酸激酶峰值达到448,000 U/升。他最初接受了强制利尿和静脉注射呋塞米治疗，但随后出现少尿，并发肺水肿，需要进行血液透析。透析3周后他完全康复。本文对相关文献进行了综述，试图勾勒出一种合理的方法来评估有横纹肌溶解风险的可卡因使用者。
