横纹肌溶解症107例诊治分析

Analysis of Diagnosis and Treatment in 107 Patients with Rhabdomyolysis

目的:探讨横纹肌溶解症(RM)的病因、临床特点、治疗及预后。方法:回顾性分析2007年1月至2017年3月我院收治的横纹肌溶解症患者107例的临床资料。结果:本组107例RM患者的病因中,前三位的是药物性(40例)、剧烈运动(14例)、感染(10例)。临床表现包括肌肉酸痛43例、肌无力43例、茶色尿14例;实验室检查示血清CK、Mb、LDH升高。合并急性肾损伤(AKI)31例,行肾脏替代治疗17例,肾脏替代治疗可显著降低血清CK、Mb、SCr水平。本组痊愈出院100例,死亡7例。结论:横纹肌溶解症病因多样,诊断主要依据临床症状和血清CK升高,AKI是其常见的合并症,肾脏替代治疗是治疗AKI的有效手段,大多数RM患者预后好。

Objective：To investigate the etiological factors,clinical characteristic,treatment and prognosis of rhabdomyolysis. Methods：The clinical data of 107 patients with rhabdomyolysis in the hospital were analyzed retrospectively from Jan 2007 to Mar 2017. Results：Among the 107 cases,the major three etiological factors were drugs（40 cases）,strenuous muscular exercise（14 cases）and infection（10 cases）. The clinical manifestation included muscular soreness（43 cases）,muscular weakness（43 cases）and pigmented urine（14 cases）. All of the patients had an increasing level of serum CK,MYO and LDH. Acute kidney injury（AKI）occurred in 31 cases. Among them,17 cases underwent renal replacement therapy（RRT）. The serum level of CK,MYO and SCr were decreased significantly after RRT in the cases. 100 cases recovered and 7 cases died. Conclusion：Rhabdomyolysis has various etiological factors. The diagnosis of the syndrome is chiefly based on clinical symptoms and high level of serum CK. AKI is the common complication of rhabdomyolysis,but RRT has good curative effect on it. Prognosis is good in most cases by active treatment.