臨床検査62巻6号

2018年06月発行

今月の特集2 筋疾患に迫る

横紋筋融解症

著者： 花房規男¹

所属機関： ¹東京女子医科大学血液浄化療法科

ページ範囲：P.753 - P.759

Point

●横紋筋融解症はさまざまな原因により骨格筋が障害され，血管透過性亢進による循環血液量の減少，急性腎障害（AKI），高カリウム血症を認める疾患である．

●血中ではクレアチニンキナーゼ（CK）が上昇し，病勢と関連する．一方，ミオグロビン尿が認められ，沈渣では赤血球を認めない尿潜血反応の原因となる．

●十分な輸液と尿のアルカリ化が図られるが，高カリウム血症は致命的であり，保存的にコントロールできない場合，乏尿・無尿では腎代替療法が行われる．

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