横纹肌溶解致急性肾损伤的发病机制及诊治进展  

Advances in Pathogenesis and Diagnosis and Treatment of Acute Renal Injury Caused by Rhabdomyolysis

作　　者：周明雪 吴春波 赵建荣[1] 孟彦 石东英[1] ZHOU Mingxue;WU Chunbo;ZHAO Jianrong;MENG Yan;SHI Dongying(Department of Nephrology,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院肾内科,呼和浩特010050

出　　处：《医学综述》2022年第3期522-526,共5页Medical Recapitulate

基　　金：国家自然科学基金(81960143,81960130)。

摘　　要：横纹肌溶解(RM)是临床常见的一种综合征,常因早期临床症状不典型、诊断不及时而延误治疗。在横纹肌细胞破坏过程中,过量的肌红蛋白等有毒成分的释放可导致急性肾损伤。RM的发病机制主要包括肾脏血管收缩、肾小管管型的形成及肌红蛋白的直接毒性作用,还可能存在其他机制共同作用。RM的治疗以药物及肾脏替代治疗为主,其中肾脏替代治疗包括连续性肾脏替代治疗等治疗模式。目前,RM行肾脏替代的治疗模式及治疗时机的选择尚无统一标准,未来可针对标准治疗方法进行深入探索。Rhabdomyolysis(RM)is a common clinical syndrome,and its treatment is often delayed due to atypical early clinical symptoms and delayed diagnosis.Excessive release of toxic components such as myoglobin during rhabdomyocyte destruction can lead to acute kidney injury.The pathogenesis of RM mainly includes renal vasoconstriction,the formation of renal tubule type and the direct toxic effect of myoglobin,and other mechanisms may also work together.RM treatment mainly consists of drugs and renal replacement therapy,and renal replacement therapy includes continuous renal replacement therapy and other treatment modes.At present,there is no unified standard for the treatment mode and timing of renal replacement for RM,and further exploration for standardized treatment can be carried out in the future.

关 键 词：横纹肌溶解 急性肾损伤 连续性肾脏替代治疗 连续性静静脉血液透析滤过 

分 类 号：R459.5[医药卫生—治疗学]