Szumilak D, Sułowicz W, Walatek B
Katedry i Kliniki Nefrologii, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 1998;55(5):274-9.
Rhabdomyolysis is a condition affecting body homeostasis that results from impaired supply of muscles with energy, nutritional factors and blood. Complex pathophysiological mechanism causes that extended myolysis may complicate different clinical conditions, such as: crush syndrome, excessive physical effort (work, seizures), toxic effect of drugs and toxins, water-electrolyte disturbances, congenital enzymatic deficiencies etc. It seems that on the cellular level, essential role is played by excessively high intracytoplasmatic calcium level, which affects metabolic processes. So high calcium level is a consequence of muscular cell injury irrespective to its reason. It manifests clinically as muscular weakness, pal and oedema and laboratory tests reveal elevated CK, GOT, GPT, aldolase and LDH levels as well as dark brown urine colour. Demonstration of elevated serum myoglobin level or its presence in urine directly confirms development of rhabdomyolysis. In unfavorable conditions, rhabdomyolysis may result in acute renal failure. Appropriately early and adequate water supply and alkalization plays an essential role in prevention of impairment in renal function. In advanced phase of renal failure, hemodialysis is a standard treatment.
横纹肌溶解症是一种影响身体内环境稳定的病症，它由肌肉的能量供应、营养因素及血液供应受损所致。复杂的病理生理机制导致广泛的肌溶解可能使不同临床病症复杂化，例如：挤压综合征、过度体力活动（工作、癫痫发作）、药物和毒素的毒性作用、水电解质紊乱、先天性酶缺乏症等。在细胞水平上，过高的胞浆钙水平似乎起着关键作用，它影响代谢过程。如此高的钙水平是肌肉细胞损伤的结果，无论其原因如何。其临床症状表现为肌肉无力、苍白和水肿，实验室检查显示肌酸激酶（CK）、谷草转氨酶（GOT）、谷丙转氨酶（GPT）、醛缩酶和乳酸脱氢酶（LDH）水平升高，以及尿液呈深褐色。血清肌红蛋白水平升高或其在尿液中的出现直接证实了横纹肌溶解症的发生。在不利情况下，横纹肌溶解症可能导致急性肾衰竭。适当早期且充足的水分供应及碱化在预防肾功能损害方面起着至关重要的作用。在肾衰竭的晚期，血液透析是标准治疗方法。
