横纹肌溶解综合症的研究进展

Progress of rhabdomyolysis syndrome

横纹肌溶解综合症(RM)是指由各种原因所致的横纹肌的破坏和崩解,使得肌酸激酶、肌红蛋白等细胞内成分进入血液循环,引起机体内环境紊乱,甚至急性肾功能衰竭的一组临床综合征。单纯的RM大多预后较好,但RM合并急性肾功能衰竭等严重并发症时,死亡率会大幅上升;研究表明,15%~40%RM患者合并急性肾功能衰竭,死亡率高达20%。明确的病因及是否合并并发症是决定患者预后的关键,近年来尽管很多学者对运动、药物、食物、感染、内分泌代谢性疾病等因素所致的RM做了一系列的动物实验及临床实验研究,但由于导致RM的病因多种多样,病理机制复杂且RM早期临床表现不典型,临床上仍很容易误诊和漏诊,更多RM的发病因素和发病机理以及合理、有效的治疗手段仍需进一步的临床研究。本文主要就RM的病因、病理机制及血液净化治疗等方面的临床研究进展作一综述,以期开拓临床医师对横纹肌溶解症的新视野,使其对RM能做到早预防、早发现、早治疗。

Rhabdomyolysis （RM） is a group of clinical syndromes.It refers to the destruction and disintegration of striated muscle caused by various causes. It makes creatine kinase, myoglobin and other intracellular components enter into the blood circulation; causes environmental disorder in body and even acute renal failure. The majority of RM have a good prognosis and it will be greatly risen when it develops ARF. Studies have shown that about 15%-40% of RM patients may concurrent with ARF, and the mortality were up to 20%. Definite etiology and complication are the key to determine the prognosis of the patients. In recent years, many researchers have done a series of animal experiments and clinical studies in RM resulting from drugs, food, infection and endocrine metabolic disease. But due to the complex pathomechanism and atypical clinical manifestation of RM, it is still easy to misdiagnosis and missed diagnosis in clinical. So, we should explore the etiology, pathogenesis and its reasonable and effective treatment. In this paper, we reviewed the clinical research progress in etiology, pathogenesis and blood purification therapy of RM aiming to exploit new views for clinical doctors and make sufficient preparation for earlier prevention, discovery and treatment.