乙醇导致横纹肌溶解症及急性肾损伤1例并文献复习  

Ethanol-induced rhabdomyolysis and acute kidney injury:A case report and literature review

作　　者：冯爱静 陈庆云[1] 焦林娟[1] 石帅[1] 王莹[1] 周杨 FENG Aijing;CHEN Qingyun;JIAO Linjuan;SHI Shuai;WANG Ying;ZHOU Yang(Department of Nephrology,Nanyang Second General Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第二人民医院肾内科,南阳473000

出　　处：《临床与病理杂志》2025年第1期122-126,共5页Journal of Clinical and Pathological Research

摘　　要：临床上运动后及挤压伤所致的横纹肌溶解症容易诊断,但乙醇所致的横纹肌溶解症及急性肾损伤相对少见。现报告1例饮酒后双下肢麻木无力的中年男性患者,脑部磁共振及椎体磁共振排除颅脑及腰椎疾病所致的双下肢无力,相关检查提示肌酸激酶、肌红蛋白高,肌酐进行性上升,诊断为乙醇致横纹肌溶解症及急性肾损伤,给予适当补液、碱化尿液等治疗,患者相关指标恢复正常。本病因乙醇通过损失细胞膜致有毒物质释放入血液、使有效循环血量不足以及引起氧化应激等所致,发病急、进展快,可出现严重的水电解质代谢紊乱、骨筋膜室综合征、弥漫性血管内凝血等,严重者危及患者生命,需要早发现、早诊治,以降低患者的病死率。Rhabdomyolysis caused by exercise or crush injuries is commonly diagnosed in clinical practice,while cases induced by ethanol leading to rhabdomyolysis and acute kidney injury are relatively rare.We report a case of a middle-aged male patient who presented with numbness and weakness in both lower limbs after alcohol consumption.Brain and spinal magnetic resonance imaging ruled out cranial and spinal diseases as the cause.Laboratory tests revealed elevated creatine kinase and myoglobin levels,with progressively increasing creatinine,leading to a diagnosis of ethanol-induced rhabdomyolysis and acute kidney injury.The patient was treated with appropriate fluid resuscitation and urinary alkalinization,resulting in normalization of laboratory indicators.The pathogenesis of this condition involves ethanol-induced disruption of the cell membrane,leading to the release of toxic substances into the bloodstream,reduced effective circulating blood volume,and oxidative stress.The disease has an acute onset and rapid progression and can lead to severe complications such as fluid and electrolyte imbalance,compartment syndrome,and disseminated intravascular coagulation,posing a serious threat to life.Early detection and timely diagnosis and treatment are essential to reduce mortality.

关 键 词：乙醇 横纹肌溶解症 急性肾损伤 水电解质代谢紊乱 肌酸激酶 

分 类 号：R692[医药卫生—泌尿科学]