定量肌球蛋白對骨骼肌壞死症之診斷價值

Diagnostic Value of Myoglobin Quantitation in Patients with Rhabdomyolysis

肌病變常會引起肌肉之傷害而表現出肌肉酵素之上升或肌球蛋白出 現在血液及尿中，本研究針對25位肌病變之病人作分析，包括6位骨將 肌溶解症病人、10位皮肌炎病人及9位其它肌病變之病人定量其血液及 尿液中的肌球蛋白，結果顯示骨骼肌溶解症之病人群之肌球蛋白值呈現 明顯之上升，此6位骨骼肌溶解症病人中，有3位肇因於低血鉀症，1 位藥物引起，1位是熱休克，1位不明原因，由於早期之診斷與治療， 此3位因低血鉀症引起骨骼肌溶解症之病人均快速的復原，並無引起常 見之腎衰竭併發症。吾人認為肌病變之病患其血液及尿中肌球蛋白之定 量對於骨骼肌溶解症之早期診斷助益良多。

Myopathy are often associated with evidence of muscle damage including a rise in serum muscle enzymes and the possible appearance of myoglobinemia and myoglobinuria. In this study, a total of 25 patients with myopathy were studied, including 6 cases of rhabdomyolysis, 10 patients with dermato-polymyositis and 9 patients with other myopathy. Their serum and urine samples were sent for quantitation of myoglobin. Prominent elevated myoglobin level was shown in the rhabdomyolysis group. Of this 6 patients, three of them resulted from hypokalemia, one from heat stroke, one from drug (gemfibrozil) and one from unknown etiology. On account of early diagnosis and management, these three hypokalemic patients improved quickly without the complication of acute renal insufficiency. Quantitation of serum and urine myoglobin levels is helpful in early diagnosis of rhabdomyolysis in patients with myopathy.