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26例儿童横纹肌溶解综合征致急性肾衰竭临床分析

孟繁英 刘小荣 付倩 陈植

中国当代儿科杂志2017,Vol.19Issue(2):193-197,5.
中国当代儿科杂志2017,Vol.19Issue(2):193-197,5.DOI:10.7499/j.issn.1008-8830.2017.02.013

26例儿童横纹肌溶解综合征致急性肾衰竭临床分析

Acute renal failure caused by rhabdomyolysis in children:a clinical analysis of 26 cases

孟繁英 1刘小荣 1付倩 1陈植1

作者信息

  • 1. 首都医科大学附属北京儿童医院肾病科,北京 100045
  • 折叠

摘要

Abstract

ObjectiveTo investigate the clinical features and prognosis of acute renal failure (ARF) caused by rhabdomyolysis (RM) in children.MethodsA retrospective analysis was performed for the clinical data, laboratory examination, and prognosis of 26 RM children with ARF.ResultsThe causes for all 26 RM children with ARF were non-traumatic diseases, and the three most common causes were infection (69%), diabetes (12%), and metabolic disease (8%). In the RM children with ARF, the ifve most frequent clinical manifestations were fever (69%), multiple organ dysfunction syndrome (69%), convulsion (46%), oliguria or anuria (35%), and tea-colored urine (27%). All 26 children had a serum creatine kinase (CK) level of >1 000 IU/L, among whom 26 had increased aspartate aminotransferase, 25 had increased alanine aminotransferase, 25 had increased creatine kinase isoenzyme, and 23 had increased lactate dehydrogenase. Serum myoglobin (Mb) was measured in 22 children and was found to increase in all these children. The mean time for CK to decrease to below 1 000 IU/L was 10±5 d. There was no signiifcant difference in the time to CK recovery between the 10 children who were treated with conventional treatment as well as continuous venous-venous hemoifltration and those who were not treated with blood puriifcation (P>0.05). Of all 26 RM children with ARF, 7 were withdrawn from the treatment, and 19 had normal renal function after treatment.ConclusionsARF and multiple organ dysfunction syndrome are major complications in RM children. The major primary disease for RM children with ARF is infectious disease. CK is the major marker for the diagnosis of RM. Early diagnosis and appropriate treatment may reverse ARF and improve prognosis.

关键词

横纹肌溶解综合征/急性肾衰竭/血液净化/肌酸激酶/肌红蛋白/儿童

Key words

Rhabdomyolysis/Acute renal failure/Blood puriifcation/Creatine kinase/Myoglobin/Child

引用本文复制引用

孟繁英,刘小荣,付倩,陈植..26例儿童横纹肌溶解综合征致急性肾衰竭临床分析[J].中国当代儿科杂志,2017,19(2):193-197,5.

中国当代儿科杂志

OA北大核心CSCDCSTPCDMEDLINE

1008-8830

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