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肌肉溶解原因有哪些 - What is the cause of muscle dissolving

文章目录

一、肌肉溶解原因有哪些
二、肌肉溶解怎么用药
三、肌肉溶解如何预防

肌肉溶解原因有哪些

1、肌肉溶解原因有哪些

肌溶解又叫做横纹肌溶解症。

横纹肌溶解症是指一系列影响横纹肌细胞膜、膜通道及其能量供应的多种遗传性或获得性疾病导致的横纹肌损伤,细胞膜完整性改变,细胞内容物(如肌红蛋白、肌酸激酶、小分子物质等)漏出,多伴有急性肾功能衰竭及代谢紊乱。

剧烈的运动如马拉松或者体操等;缺血或组织坏疽(可能并发有动脉栓塞,深度静脉栓塞或其它病症);癫痫发作;过量服用药物,特别是可卡因、安非他明、海洛因或者PCP(五氯酚)以及某些降脂药。肌肉溶解原因有哪些 - What is the cause of muscle dissolving

2、肌肉溶解的临床表现

可见肌肉的疼痛、压痛、肿胀及无力等肌肉受累的情况,亦可有发热、全身乏力、白细胞和(或)中性粒细胞比例升高等炎症反应的表现,尿外观:呈茶色或红葡萄酒色尿。因本病大约30%会出现急性肾衰竭,当急性肾衰竭病情较重时,可见少尿、无尿及其他氮质血症的表现。

3、肌肉溶解怎么检查

血液检查

生化检查示血清肌酶及其他肌酶(肌酸激酶,转氨酶、醛缩酶、乳酸脱氢酶等)增高;肌酐、尿素氮、尿酸水平升高,高钾、高磷,代谢性酸中毒;可伴血小板减少及弥散性血管内凝血等血液系统异常;肌红蛋白血症。

尿液检查

肌红蛋白尿,尿常规:常有蛋白尿;尿沉渣:无红细胞或少量红细胞、颗粒管型,尿肌红蛋白升高,尿二羧基酸排泄。肌肉溶解原因有哪些 - What is the cause of muscle dissolving

肌肉溶解怎么用药

他汀类药物:如辛伐他汀、西立伐他汀(拜斯亭)、普伐他汀、阿托伐他汀等均可导致发病。横纹肌溶解症早在洛伐他汀上市后的第2年就有许多相关报道,而后证实所有他汀类药物均有此不良反应,是他汀药物主要的不良反应。他汀药物和苯氧酸衍生物(贝特类降脂药)合用更易引起横纹肌溶解症。国内外文献报道的大部分病例均是治疗剂量时发生,但出现时间在服药后36小时~24月不等,一般发生在用药后3个月,其发病率<1%。同时服用环孢素、烟酸衍生物、伊曲康唑、红霉素、克拉霉素、阿奇霉素和米贝拉地尔等影响细胞色素P450酶系(肝药物代谢酶)药物的患者更易发生该症。肌肉溶解原因有哪些 - What is the cause of muscle dissolving

秒速快3西立伐他汀1997年上市后,因服该药导致横纹肌溶解症而致死者高于其他他汀类药物的20倍,当时全球共有52例因服用本药产生横纹肌溶解所致的死亡报告,且多见于高剂量用药者及老年患者,尤其是与吉非贝齐合用易发生,2001年,拜耳公司即从全球市场主动撤出西立伐他汀。

贝特类药物:非诺贝特主要的不良反应为胃肠道反应、皮肤过敏反应、肝肾功能损害,最严重的不良反应是横纹肌溶解症,近年来国内外均有病例报道。非诺贝特引起横纹肌溶解症的病例多发生于肾功能不全的患者。由于非诺贝特是经肾排泄,常规剂量的非诺贝特对肾功能不全的患者可能剂量过大。

肌肉溶解如何预防

既然治疗这种病症难,那我们就该从现在开始,着重预防,不要到将来后悔莫及。预防横纹肌溶解症的方法最基本是避免一次性超负荷运动,要在任何可能损伤到骨骼肌的情况下,补充足够的液体来冲淡肾里面的肌血球素。之后,必须要注意忌口,尤其是有过敏性体质的人、肾脏病、胃肠炎、痛风病人不能多吃龙虾,糖尿病、便秘、咽喉炎、口腔溃疡的患者也要特别谨慎。


Article catalogues

1. What are the reasons for the dissolving of muscles
Two. How do the muscles dissolve
Three. How to prevent muscle dissolving

What is the cause of muscle dissolving

1。 What are the reasons for the dissolving of muscles

Rhabdomyolysis is called rhabdomyolysis.

Rhabdomyolysis is a series of effects of striated muscle cell membrane, the membrane channel and its energy supply a variety of inherited or acquired diseases caused by rhabdomyolysis, cell membrane integrity, cell contents (such as myoglobin, creatine kinase, small molecular substances) leakage, failure and metabolic disorders associated with acute kidney.

Strenuous exercise such as marathons or gymnastics; ischemia or tissue necrosis (possibly associated with arterial embolism, deep vein embolism or other disorders); epilepsy; an overdose of drugs, especially cocaine, heroin, amphetamine or PCP (PCP) and certain lipid-lowering drugs. 肌肉溶解原因有哪些 - What is the cause of muscle dissolving

2. The clinical manifestation of muscle dissolving

Visible muscle pain, tenderness, swelling and weakness and other muscle involvement, also can have fever, fatigue, leukocyte and / or neutrophils increased and other inflammatory reactions, the appearance of urine: tea or red wine color urine. Acute renal failure occurs in about 30% of this disease. When acute renal failure is severe, oliguria, no urine and other azidemia are seen.

秒速快33. How does the muscle dissolve check

Blood examination

Biochemical examination showed serum muscle enzymes and other muscle enzymes (creatine kinase, aldolase, transaminase, lactate dehydrogenase) increased; creatinine and urea nitrogen, uric acid, potassium, phosphorus, metabolic acidosis; can the abnormal with thrombocytopenia and disseminated intravascular coagulation of blood; myoglobinaemia。

Urine examination

Myoglobin urine, urine routine: often have albuminuria; urine sediment: no red cells or a small number of red cells, granular tube type, urine myoglobin increased, urine two carboxyl acid excretion. 肌肉溶解原因有哪些 - What is the cause of muscle dissolving

How do muscle dissolve use

Statins: such as simvastatin and cerivastatin (lipobay), pravastatin and atorvastatin can cause disease. Rhabdomyolysis early in lovastatin after the listing of second years there have been many reports, and then confirmed that all statins have the adverse reaction, is the main adverse reactions of statins. Statins and phenoxy acid derivatives (fibrates) combination is more likely to cause rhabdomyolysis. Most of the reported cases at home and abroad occurred at the dose of treatment, but the time was 36 hours after taking medicine for ~24 months, and the incidence was 3 months after medication. The incidence of < was 1%. At the same time, cyclosporine, nicotinic acid derivatives, itraconazole, erythromycin, clarithromycin, azithromycin, and Bella and so on affect the cytochrome P450 enzymes (liver drug metabolizing enzymes) more easily. 肌肉溶解原因有哪些 - What is the cause of muscle dissolving

Cerivastatin in 1997 after the listing, because of taking the drug induced rhabdomyolysis caused dead 20 times higher than that of other statins, the global total of 52 cases of rhabdomyolysis caused death caused by taking the drug, especially in high dose and elderly patients, especially with non Kyrgyzstan Betsey combination is easy to occur, in 2001, Bayer that atorvastatin from the global market active withdrawal of cerivastatin.

秒速快3Fibrates: the main adverse reactions of fenofibrate were gastrointestinal reaction and allergic skin reactions, liver and kidney dysfunction, the most serious adverse reaction is rhabdomyolysis, in recent years at home and abroad have reported cases. Fenofibrate caused rhabdomyolysis cases occurred in patients with renal insufficiency. As fenofibrate is excreted through the kidney, the regular dose of fenofibrate may be overdose in patients with renal insufficiency.

How to prevent muscle dissolving

Since it is difficult to treat this disease, we should start from now, focus on prevention, and do not repent in the future. The most basic way to prevent rhabdomyolysis is to avoid a one-time overexercise. In any possible damage to skeletal muscle under the condition of enough liquid to dilute the kidney inside of myoglobin. After that, must pay attention to diet, especially allergic physique, kidney disease, gastroenteritis, gout patients can not eat lobster, diabetes, constipation, pharyngitis, oral ulcer patients also need to be cautious.

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