On the mechanism of rhabdomyolysis in potassium depletion.
On the mechanism of rhabdomyolysis in potassium depletion.
复制标题
钾缺乏导致横纹肌溶解症的机制。
DOI：
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发表时间：
1972
影响因子：
15.9
通讯作者：
E. Schlein
中科院分区：
文献类型：
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作者：
J. Knochel;E. Schlein
横纹肌溶解症和肌红蛋白尿常见于在炎热气候下进行高强度体育训练时遭受环境热损伤的男性。这些也发生在钾缺乏的患者中。由于在炎热气候下进行体育锻炼可能伴随着体内钾的严重流失，因此认为钾缺乏时进行剧烈运动可能会增加横纹肌溶解症的易感性。钾从收缩的骨骼肌纤维中释放出来，其在间质液中浓度的升高被认为会扩张小动脉，从而介导运动期间肌肉血流量的正常升高。如果缺钾肌肉的钾释放低于正常水平，则运动不会伴随有足够的肌肉血流量，缺血可能会发生横纹肌溶解。通过比较电刺激运动对正常狗和缺钾狗的完整股薄肌标本的肌肉血流量、钾释放和组织学的影响来检验这一假设。在正常的狗中，肌肉血流量和钾释放在运动期间急剧上升。与此相反，肌肉血流量和钾释放显着低于正常的耗尽狗，尽管轻快的肌肉收缩。尽管在非运动的钾耗竭肌肉中有时观察到轻微的组织学变化，但在运动后每只钾耗竭动物中均发生了明显的横纹肌溶解。这些发现支持缺血可能是运动性缺钾横纹肌溶解症的机制的假设。
Rhabdomyolysis and myoglobinuria occur commonly in men who sustain environmental heat injury during intensive physical training in hot climates. These also occur in patients with potassium depletion. Since physical training in hot climates may be accompanied by serious losses of body potassium, the possibility was considered that performance of strenuous exercise when potassium deficient might enhance susceptibility to rhabdomyolysis. Potassium is released from contracting skeletal muscle fibers and its rising concentration in interstitial fluid is thought to dilate arterioles thereby mediating the normal rise of muscle blood flow during exercise. If potassium release from deficient muscle were subnormal, exercise would not be accompanied by sufficient muscle blood flow and rhabdomyolysis could occur by ischemia. This hypothesis was examined by comparing the effect of electrically stimulated exercise on muscle blood flow, potassium release, and histology of the intact gracilis muscle preparation in normal and potassium-depleted dogs. In normal dogs, muscle blood flow and potassium release rose sharply during exercise. In contrast, muscle blood flow and potassium release were markedly subnormal in depleted dogs despite brisk muscle contractions. Although minor histologic changes were sometimes observed in nonexercised potassium-depleted muscle, frank rhabdomyolysis occurred in each potassium-depleted animal after exercise. These findings support the hypothesis that ischemia may be the mechanism of rhabdomyolysis with exercise in potassium depletion.