原发性醛固酮增多症合并横纹肌溶解2例并文献复习
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Primary aldosteronism associated with rhabdomyolysis: a report of 2 cases and review of the literature
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    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。

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    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.

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覃洪艳,龚莉琳,王瑶,白洁,任伟,宋颖,李启富,汪志红.原发性醛固酮增多症合并横纹肌溶解2例并文献复习[J].重庆医科大学学报,2018,(6):763-

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  • 在线发布日期: 2019-05-23
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