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頁籤選單縮合
題名 | Non-traumatic Rhabdomyolysis and Acute Renal Failure=非外傷性橫紋肌溶解症與急性腎衰竭 |
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作者姓名(中文) | 范姜群毅; 方基存; 黃秋錦; | 書刊名 | 長庚醫學 |
卷期 | 19:1 1996.03[民85.03] |
頁次 | 頁10-15 |
分類號 | 415.815 |
關鍵詞 | 橫紋肌溶解症; 急性腎衰竭; Rhabdomyolysis; Acute renal failure; |
語文 | 英文(English) |
中文摘要 | 橫紋肌解症的臨床表是由於肌肉組織遭破壞造成肌肉細胞內容物在血中及尿中不正常的上升,在過去的文獻報告,不止外性肌肉溶解症會導致急性腎衰竭,非外傷性肌肉溶解症所造成的性腎衰竭亦漸漸為大家重視。我們回顧長庚醫院過去五年中被診斷非外傷性肌肉溶解症的三十一位病人,並探討非外傷性肌肉溶解症的原因、生化檢驗、臨床病程、併發症、和預後。造成非外傷性允肉溶解症的原因以藥物成癮、癲癇、和過度活動最常見。臨床症狀以肌肉腫症為最多。三十一位病人中有二十八位於住院時有作尿液檢查,其中二十一位出現蛋白尿,十六位出現顯血尿,對於血基質和肌球素十分敬感的檢查方法:Orthotolidine檢測法,五位陰性反應,另有七位病人在沒有顯微血尿的情況下出現陽性反應。十七病人發生急性腎衰竭,比較急性腎衰竭病人與沒有腎衰竭病人的生化檢查,發現發生急性腎衰竭的病人有較高數值的鉀離子、和尿酸。十七位性腎衰竭病患中有九位需要作血液透析治療,平均透析時間為十五天。除了一位病人在二個月的追?仍未恢復腎臟功能。有二位病人死亡,這二位都發生敗血症合併多器官衰竭。 |
英文摘要 | Thirty-one patients (26 males, 5 females) with man age 35±19 year (range 8 to 85 year) were diagnosed as non-traumatic rhabdomyloysis by clinical findings and elevation of serum creatine kinase (CK) between January 1989 and December 1993. Causes, laboratory measures, clinical courses, and outcome were reviewed retrospectively. Drug abuse, seizure, and excessive activity are the most common etiologies for non-traumatic rhabdomylysis. Twelve patients presented with muscular pain and seven patients with muscle weakness. Twenty eight patients had urinalysis and five of them (18%) had negative orthotolidine dipstick test. Only seven patients (25%) were detected postitive orthtolidine test without microscopic hematuria. Patients with acute renal failure had higher levels of potassium and uric acid. The patients who developed acute renal failure after admission had significantly higher levels of uric acid. The peak levels of CK did not correlated with development of acute renal failure. There was no episode of hyercalemia. Seventeen patients (55%) had acute renal failure. Hemodialysis was required in nine cases. All survivors recovered with normal renal function except one who needed maintenance hemodialysis after two months follow-up. Two patients died of multi-organ failure and sepsis. |
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