肌红蛋白尿性急性肾衰竭12例诊断与治疗

• 作 者: 王锋 晏春根 汪年松 薛勤 严艳 高许萍 崔勇平 俞岗
• 机 构: 上海交通大学附属第六人民医院肾脏科,绍兴文理学院医学院附属医院内科,上海交通大学附属第六人民医院肾脏科,上海交通大学附属第六人民医院肾脏科,上海交通大学附属第六人民医院肾脏科,上海交通大学附属第六人民
• 出 处: 中国全科医学
• 发表日期: 2004年21期
• 关键词: 肌红蛋白尿 急性肾功能衰竭

目的　探讨肌红蛋白尿性急性肾衰竭 (MARF)的诊断与治疗。方法　 12例MARF病例 ,其中创伤性MARF 5例、非创伤性MARF 7例。常规检测其血电解质、肾功能、肌酸激酶、肌红蛋白与尿肌红蛋白 ,予以血液净化治疗 ,观察少尿期持续时间及其预后。结果　创伤性MARF两组患者 ,Scr、BUN、UA、CPK、血Mb、血钙与非创伤性MARF两组差异无显著性意义 (P >0 0 5 )。 9例MARF患者尿肌红蛋白阳性。非创伤性MARF组与创伤性MARF组少尿期时间差异有显著性意义 (P <0 0 5 ) ,两组分别有 1例、 2例死亡。结论　肌酸激酶与肌红蛋白检测有助于MARF的诊断 ,早期与持续充分血液净化治疗有助于改善预后。

Objective To investigate the diagnosis and treatment of myoglobinuria acute renal failure (MARF). Methods 12 cases of MARF cases, including 5 cases of traumatic MARF, 7 cases of non-traumatic MARF. Routine detection of blood electrolytes, renal function, creatine kinase, myoglobin and urine myoglobin, to be blood purification treatment, observation of oliguria duration and prognosis. Results There was no significant difference in the two groups of patients with traumatic MARF between the two groups (Scr, BUN, UA, CPK, blood Mb, serum calcium and non-invasive MARF) (P> 0.05). Nine patients with MARF were positive for myoglobin. There was a significant difference in the time of oliguria between non-traumatic MARF group and traumatic MARF group (P <0.05), with one case in each group and two cases died. Conclusion The detection of creatine kinase and myoglobin is helpful for the diagnosis of MARF. Early and continuous treatment of blood purification can improve the prognosis.