[惊厥性肌红蛋白尿后急性肾功能衰竭]。

No to shinkei = Brain and nerve Pub Date : 2006-09-01
Yuji Hashimoto, Ryuichi Katada, Satoshi Iihoshi, Jun Niwa
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引用次数: 0

摘要

一名75岁女性,8年前有壳膜出血病史,因全身性惊厥持续40分钟而入院。静脉注射地西泮后抽搐反应迅速,但此后持续深度昏迷。虽然在此发作前肾功能已恢复正常,但尿量立即被估计为有限。开始滴注林格氏液,并联合给药速尿和甘露醇。入院后6小时的实验室值显示GOT、GPT、CPK、BUN和Cr水平极高,提示横纹肌溶解。尿检证实为肌红蛋白尿。尽管进行了大量的利尿剂治疗,但肾功能未见改善,于住院第4天死亡。治疗结果可能受患者入院时脱水和酸中毒的一般情况以及抽搐引起的肌肉损伤的影响。肌红蛋白尿可引起危及生命的肾衰竭,并可由惊厥引起。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Acute renal failure following convulsion-induced myoglobinuria].

A 75-year-old female with history of putamenal hemorrhage 8 years earlier was admitted to our hospital with generalized convulsion lasting 40 minutes. Convulsion responded quickly to intravenous administration of diazepam, but deep coma persisted thereafter. Although renal function had normalized before this episode, urinary output was immediately estimated to be limited. Drip-infusion of Ringer's solution and the combined administration of furosemide and mannitol were started. The laboratory values 6 hours after admission demonstrated extremely elevated GOT, GPT, CPK, BUN and Cr levels, suggesting rhabdomyolysis. Urinalysis confirmed myoglobinuria. Despite massive diuretic therapy, renal dysfunction did not improve and she died on hospital day 4. The treatment outcome was probably influenced by her general condition of dehydration and acidosis at admission, as well as muscle damage caused by convulsion. Myoglobinuria can induce life-threatening renal failure, and may be caused by convulsion.

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