摘要
目的:探讨原发性醛固酮增多症(简称原醛症)伴横纹肌溶解的临床特点以指导对该病的诊治。方法:对我院诊断的2例原醛症伴横纹肌溶解及文献中检索到的19例该病患者进行分析。结果:所有患者均有高血压病史,主要表现为乏力、肌痛、低钾血症及高肌酶谱,少部分患者有肌红蛋白尿、肾损伤及转氨酶异常。经大量补液、碱化尿液等对症治疗,横纹肌溶解得以纠正,而经过手术或药物治疗后血钾、血压恢复正常。结论:对于原醛症的高危人群应尽早进行筛查,可避免病情进展而导致横纹肌溶解等严重并发症的发生,而对于确诊为原醛症的患者,血钾低于2.0 mmol/L的醛固酮腺瘤应警惕横纹肌溶解的发生。已出现横纹肌溶解的原醛症患者,应在积极对症治疗的基础上根治原发病。
Objective:To investigate the clinical features of primary aldosteronism associate with rhabdomyolysis and to guide the diag- nosis and treatment of the disease. Methods :The presentation and symptoms of the two patients in our hospital were described and the relevant literature was reviewed. A thorough literature search disclosed 19 further cases of rhabdomyolysis due to undiagnosed pri- mary aldosteronism. Results : All patients had a history of hypertension, including fatigue, myalgia, hypokalemia and high muscle en- zymes,and there were a small number of patients who had abnormal myoglobinuria,acute renal failure and abnormal liver enzyme. Rhabdomyolysis was cured by a large amount of fluid and urine alkalization. All patients were restored to normal blood pressure and normal serum potassium levels after drug or adrenal surgical interventions. Conclusion:For the high risk population of primary aldos- teronism,early screening should be conducted to prevent disease progression and serious complications such as rhabdomyolysis,and for patients with dignosed primary aldosteronism whose serum potassium is lower than 2.0 mmol/L,rhabdomyolysis should be alerted. Primary aldosteronism patients with rhabdomyolysis should actively receive symptomatic treatment and cure the primary disease.
作者
覃洪艳
龚莉琳
王瑶
白洁
任伟
宋颖
李启富
汪志红
Qin Hongyan;Gong Lilin;Wang Yao;Bai Jie;Ren Wei;Song Ying;Li Qifu;Wang Zhihong(Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical Universit)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2018年第6期763-767,共5页
Journal of Chongqing Medical University
基金
国家临床重点专科建设资助项目(编号:2011)
重庆市医学高端后备人才培养资助项目(编号:渝卫人[2015]49号)