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学科主题: 呼吸内科学
题名:
重症肺炎并发横纹肌溶解症与急性肾衰竭的诊断治疗并文献复习
其他题名: Diagnosis and treatment of severe pneumonia complicated with rhabdomyolysis,acute renal failure and review of literatures
作者: 周庆涛; 沈宁; 孙丽娜; 王蒙; 贺蓓
关键词: 肺炎 ; 横纹肌溶解症 ; 急性肾衰竭 ; Pneumonia ; Rhabdomyolysis ; Acute renal failure
刊名: 中华医院感染学杂志
发表日期: 2015
DOI: 10.11816/cn.ni.2015-141301
期: 1, 页:134-136
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的:探讨肺炎并发横纹肌溶解症、急性肾衰竭的诊断和治疗,改善患者预后。方法分析两例重症肺炎患者的临床表现和诊治过程,并检索2004-2013年共10年的文献进行复习。结果两例重症肺炎患者均为男性,分别为40、62岁,血清肌酸激酶(CK)升高分别达10109、8406 U/L,伴肌红蛋白尿、血肌酐升高分别达242、721μmol/L;病例1因严重低氧血症给予机械通气治疗,病例2因严重肾衰竭接受血液透析,治疗后二者呼吸和肾功能均完全恢复;文献检索到肺炎并发横纹肌溶解症、急性肾衰竭病例20例,年龄24~85岁,男性16例占80.0%;病原体主要为军团菌7株、甲型流感病毒5株和葡萄球菌属5株(耐甲氧西林菌株4株);8例接受机械通气治疗,11例接受血液净化治疗,6例患者同时接受机械通气和血液净化治疗,其中死亡3例、存活17例,其中16例肾功能完全恢复。结论肺炎并发横纹肌溶解症、急性肾衰竭临床少见,病情严重需同时接受机械通气和血液净化治疗者死亡风险高,而存活患者的肾功能几乎均能恢复正常。 OBJECTIVE To explore the diagnosis and treatment of severe pneumonia complicated with rhabdomyoly-sis,acute renal failure and improve the prognosis of the patients.METHODS The clinical manifestations,diagno-sis,and treatment of 2 patients with severe pneumonia were analyzed,and the literatures were retrieved from 2004 to 2013 and were reviewed.RESULTS The two cases of severe pneumonia were male,they were 40 and 62 years old,respectively,the levels of creatine kinase (CK)were elevated by 10 109 and 8 406 U/L,respectively,the levels of myoglobinuria,creatinine were elevated by 242 and 721μmol/L,respectively.Patient 1 was treated with mechanical ventilation due to severe hypoxemia,and patient 2 received hemodialysis due to severe renal failure.Af-ter the treatment,the respiratory and renal functions of both patients recovered completely.Totally 20 cases of pneumonia complicated with rhabdomyolysis,acute renal failure have been retrieved from the literatures,with the age ranging between 24 and 85 years old,and 16 cases were male,accounting for 80.0%.The Legionella (7 strains),influenza A virus (5 strains),and Staphylococcus spp (5 strains,and 4 methicillin-resistant strains) were the major species of pathogens.Totally 8 cases received the mechanical ventilation,11 cases received the blood purification therapy,and 6 cases received the mechanical ventilation and the blood purification therapy at the same time;3 cases died,1 7 cases survived,among whom 1 6 cases had the complete recovery of renal function. CONCLUSION The pneumonia complicated with rhabdomyolysis,acute renal failure is rare,the severe patients who need both the mechanical ventilation and the blood purification therapy are at a higher risk of death,while al-most all of the survivors can regain their full renal functions.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/71307
Appears in Collections:北京大学第三临床医学院_呼吸内科_期刊论文

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作者单位: 北京大学第三医院呼吸内科,北京,100191

Recommended Citation:
周庆涛,沈宁,孙丽娜,等. 重症肺炎并发横纹肌溶解症与急性肾衰竭的诊断治疗并文献复习[J]. 中华医院感染学杂志,2015(1):134-136.
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