感染症に合併した横紋筋融解症の発生機序は、筋を障害する毒素か、病原体の直接浸潤もしくはサイトカインの関与が推測されている。症状は下腿を中心に出現し易いとの報告もあり我々は定期的な身体観察が必要であったと反省する。
MNMSにより急性腎不全が発症する原因は①高カリウム血症による心拍出量の低下、②横紋筋融解を起こした四肢の浮腫による前負荷軽減、が挙げられる。ミオグロビンは腎動脈を収縮させる以外に尿細管内に析出し円柱を形成し尿細管を閉塞したり直接尿細管細胞を障害する。
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Translation / English
- Posted at 12 Feb 2012 at 03:17
In generation mechanism of rhabdomyolysis complicated with infectious disease, toxin for muscle disorder, direct invasion of pathogen, or participation of cytokine are estimated. Considering one report that the symptoms tended to be emerged mainly in lower leg, we should have implemented body observations constantly.
Some causes of acute renal failure by MNMS are listed that one is low cardiac output by hyperkalemia and another one is preload reduction from the edema in limbs caused by rhabdomyolysis. Myoglobin can constricts renal artery and also can be deposited to form columes in an uriniferous tubule so that the uriniferous tubule is blocked or the cells are directly attacked.
Some causes of acute renal failure by MNMS are listed that one is low cardiac output by hyperkalemia and another one is preload reduction from the edema in limbs caused by rhabdomyolysis. Myoglobin can constricts renal artery and also can be deposited to form columes in an uriniferous tubule so that the uriniferous tubule is blocked or the cells are directly attacked.
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50
Translation / English
- Posted at 12 Feb 2012 at 10:09
As the rhabdomyolysis mechanisms merged from infectious diseases, a toxin to the cause of the failure of the muscle, or pathogens directly involved in the invasion or cytokines are now estimated. It is reported that symptoms are easy to occur mainly in a lower part of the thigh, and we reflect that the regular body monitoring was needed.
The causes of the acute renal failure due to MNMS are: [1] the decline of hyperkalemic cardiac output due to MNMS, [2] the pre-load reduction due to edema of limbs caused by rhabdomyolysis.
In addition to shrinking a renal artery, myoglobin deposits in a nephric tubule and causes a capillary blockage, or it carries out the obstacle of the renal tubular cell directly.
The causes of the acute renal failure due to MNMS are: [1] the decline of hyperkalemic cardiac output due to MNMS, [2] the pre-load reduction due to edema of limbs caused by rhabdomyolysis.
In addition to shrinking a renal artery, myoglobin deposits in a nephric tubule and causes a capillary blockage, or it carries out the obstacle of the renal tubular cell directly.
