摘要
目的探讨嗜肺军团菌肺炎并发横纹肌溶解症的诊断和治疗,以改善患者的预后。方法分析一例嗜肺军团菌肺炎并发横纹肌溶解症的临床表现与诊治过程,检索2006至2016年共10年的国内文献进行复习。结果一例嗜肺军团菌并发横纹肌溶解症患者男性,肌酸激酶(CK)为2 171 U/L,肌红蛋白(MYO)为313 ng/ml,血肌酐水平正常,给予积极补液、碱化尿液、利尿等对症治疗后CK及Myo恢复正常。国内文献共检索嗜肺军团菌并发横纹肌溶解症病例5例,年龄26~82岁,男性4例、女性1例,3例患者有使用空调史,其CK水平为1 641~13 600 U/L,4例患者肌酐升高168~699μmol/L,均给予了补液、碱化尿液、利尿对症,3例患者接受连续性床旁血滤支持治疗后肾功能恢复正常。结论嗜肺军团菌肺炎并发横纹肌溶解症临床少见,早期诊断、及时有效地针对病原学和并发症治疗有助于改善预后。
Objective To investigate the diagnosis and treatment of Legionella pneumonia complicated with rhabdomyolysis and to improve the prognosis of patients. Methods The clinical manifestation and treatment process of one patients with Legionella pneumonia complicated with rhabdomyolysis were analyzed, and the literature retrieved from 2006 to 2016 and were reviewed. Results The Case of Legionella pneumophila complicated with rhabdomyolysis was male, whose level of creatine kinase （CK） and myoglobin （MYO） were elevated by 2 171 U/L and 313 ng/ml, repectively, serum creatinine was normal. The levels of CK and MYO returned to normal after symptomatic treatment such as positive fluid replacement, alkalization of urine and diureses. Total 5 cases ofLegionella pneumophila complicated with rhabdomyolysis have been retrieved from the literatures, with the age 26-82 years old, and 4 cases were male. Among them, 3 cases had the history of air-conditioning, the levels of CK were 1 641-13 600U/L, 4 patients with elevated creadnine （168-699μmol/L）. All patients had received rehydration, alkaline urine, diuretic symptomatic treatment. The renal function of 3 cases returned to normal after continuous bedside hemofiltration support. Conclusions Legionella pneumophila complicated with rhabdomyolysis is rare. Early diagnosis, timely and effective treatment of etiology and complications could help to improve the prognosis.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2017年第6期622-624,共3页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
北京市科技计划基金项目(No.D151100002115004)
关键词
肺炎
嗜肺军团菌
横纹肌溶解
Pneumonia
Legionella pneumonia
Rhabdomyolysis
