内分泌疾病并发横纹肌溶解综合征的临床分析  

Clinical features of endocrine diseases complicated with rhabdomyolysis

作　　者：高楚淇 袁佳 樊丽娅 李梦祎 郭辉[1] 施秉银[1] 强薇[1] GAO Chuqi;YUAN Jia;FAN Liya;LI Mengyi;GUO Hui;SHI Bingyin;QIANG Wei(Department of Endocrinology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Emergency Department,Xi'an Hospital of Civil Aviation,Xi'an 710082;Department of Endocrine and Rheumatology Immunology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710089,China)

机构地区：[1]西安交通大学第一附属医院内分泌科,陕西西安710061 [2]民航西安医院急诊科,陕西西安710082 [3]西安交通大学第一附属医院东院内分泌免疫科,陕西西安710089

出　　处：《西安交通大学学报（医学版）》2020年第6期919-922,共4页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.81802829);陕西省自然基础研究资助项目(No.2020JQ-501)。

摘　　要：目的探讨内分泌疾病并发横纹肌溶解综合征(rhabdomyolysis,RM)的临床及实验室特征。方法选取2008年6月至2019年5月在西安交通大学第一附属医院收治的144例RM患者中,回顾性分析10例内分泌疾病并发RM患者的临床表现、实验室检查及诊治经过。结果导致RM的内分泌病因以原发性甲状腺功能减退症最为多见,其他病因为糖尿病并发症包括糖尿病酮症、高血糖高渗、糖尿病肾病等及原发性醛固酮增多症、库欣综合征等。内分泌疾病导致的RM起病较为隐匿,缺乏典型的肌痛、肌无力、茶色尿三联征,较少发生急性肾功能损伤、多脏器功能衰竭等并发症,较少需要进行血液净化治疗,经常规补液、碱化尿液等治疗均预后较好。结论多种内分泌疾病可引起RM,且临床表现常不典型,临床医师应提高警惕。治疗RM时应结合原发疾病特征,改善患者预后。Objective To investigate the clinical and laboratory characteristics of endocrine diseases complicated with rhabdomyolysis(RM).Methods We made a retrospective analysis of clinical features,diagnosis and treatment of 10 cases of endocrine diseases induced RM among 144 RM patients admitted to The First Affiliated Hospital of Xi'an Jiaotong University from June 2008 to May 2019.Results Primary hypothyroidism was the most common endocrine etiology leading to RM.Other etiologies included diabetic ketosis,hyperglycemic hyperosmolar syndrome,diabetic nephropathy,hyperaldosteronism and Cushing syndrome.The onset of RM caused by endocrine diseases was insidious,lacking the typical triad of myalgia,muscle weakness and colored urine.Complications such as acute kidney injury and multiple-organ dysfunction syndrome were less common in RM caused by endocrine diseases.These patients seldom needed continuous renal replacement therapy,and good prognosis could be attained via routine fluid infusion and alkalization treatment.Conclusion Many endocrine diseases can cause RM and their clinical manifestations are often atypical.Clinicians should be vigilant for early identification.Treatment should be comprehensive to improve the prognosis.

关 键 词：横纹肌溶解综合征 甲状腺功能减退症 糖尿病 原发性醛固酮增多症 库欣综合征 

分 类 号：R685.5[医药卫生—骨科学]