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肌红蛋白尿由骨骼肌损伤所致,常见原因有用力过猛.挤压伤、持续性惊厥状态、代谢紊乱(低钾血症)、各种毒素尤其酒精和海洛因,以及进行性肌病例如多肌炎。肌红蛋白尿的常见并发症为急性肾小管坏死。作者报告1例女性、34岁,有吸食海洛因和饮酒史。在利尿剂降压疗法中发生四肢无力和压痛、血清酶峰值增加:SGOT 2100 mlU/ml,LDH1124 mlU/ml伴有同功酶 LDH_5增加,CPK15356 mIW/ml伴同功酶MB阳性。尿色发暗,肌红蛋白阳性。心电图皇窦性心律,Ⅰ、Ⅱ、Ⅲ、aVF、V_3～V_6导联ST段下降,T波倒置.M-型超声心动图和铊闪烁图证明心脏正常,冠脉造影正常。腓肠肌活组织检查有新鲜坏死.8个月后,肌无力和压痛消失,心电图也随之恢复正常.
Myoglobinuria is caused by skeletal muscle injury, common causes of excessive force squeeze injury, persistent convulsions, metabolic disorders (hypokalemia), various toxins, especially alcohol and heroin, and progressive myopathy such as Polymyositis. A common complication of myoglobinuria is acute tubular necrosis. The authors report a female, 34 years old, with heroin and alcohol consumption history. In the diuretic antihypertensive therapy limb weakness and tenderness occurred, serum enzyme peak increased: SGOT 2100 mlU / ml, LDH1124 mlU / ml with isozyme LDH_5 increased, CPK15356 mIW / ml with isozyme MB positive. Dark urine color, myoglobin positive. The electrocardiogram (ECG) sinus rhythm, ST segment depression and T wave inversion of Ⅰ, Ⅱ, Ⅲ, aVF and V_3 ~ V_6 lead.M-echocardiography and thallium scintigraphy proved that the heart was normal and coronary angiography was normal. Gastrocnemius muscle biopsy fresh necrosis .8 months later, muscle weakness and tenderness disappeared, ECG also will return to normal.