3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习

具杨花; 乔红梅; 张影; 李亚男

doi:10.24920/003663

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3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习

中国医学科学杂志（英文版） 2020年35卷第4期页码：383-386

Case Report | Updated：2024-04-10

- 3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习
- Affiliations：
  
  Department of Pediatrics, the First Hospital of Jilin University, Changchun 130021, China
- Author bio：
  
  * E-mail: lyanan2008@sina.com
- Funds：
  
  National Natural Science Foundation of China;国家自然科学基金(81770026);Natural Science Foundation of Jilin Province;吉林省自然科学基金(20180101157JC)
- DOI：10.24920/003663
  中图分类号：
- 收稿日期：2019-09-23，
  
  录用日期：2020-3-14，
  
  网络出版日期：2020-12-31，
  
  纸质出版日期：2020-12-31
- Accepted：
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具杨花, 乔红梅, 张影, 等. 3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习[J]. 中国医学科学杂志（英文版）, 2020,35(4):383-386.

Ju Yanghua, Qiao Hongmei, Zhang Ying, et al. Three Cases of Rhabdomyolysis Induced by Viral Infections in Children and Literature Review[J]. Chinese medical sciences journal, 2020, 35(4): 383-386.
具杨花, 乔红梅, 张影, 等. 3例病毒相关性儿童横纹肌溶解症的临床分析与文献复习[J]. 中国医学科学杂志（英文版）, 2020,35(4):383-386. DOI： 10.24920/003663.

Ju Yanghua, Qiao Hongmei, Zhang Ying, et al. Three Cases of Rhabdomyolysis Induced by Viral Infections in Children and Literature Review[J]. Chinese medical sciences journal, 2020, 35(4): 383-386. DOI： 10.24920/003663.

摘要

回顾分析了3例由不同病毒感染所致的儿童横纹肌溶解症患者的临床症状、体征、酶学变化和肌肉活检病理表现、诊治经过及病情转归。病例1为甲型流感病毒感染的11岁男孩

主要表现为发热、咳嗽和肌痛。经积极抗病毒、水化、碱化治疗

患者病情完全恢复。病例2为EB病毒感染的10岁女孩

有明显的肌肉疼痛和肌无力症状

肌酸激酶明显升高;经积极补液和抗感染治疗

患者恢复正常。病例3为人巨细胞病毒感染的15岁男孩

以反复发热为主要症状

并伴有肌痛、面部水肿;抗菌治疗无效

出现呼吸肌无力和多脏器损伤;经抗病毒、呼吸支持和血液滤过治疗后

病情好转

无后遗症。结合文献回顾

尽管流感病毒、EB病毒和巨细胞病毒在儿童中很少引起横纹肌溶解症

但应引起重视。经早期诊断和治疗

上述病毒引起的横纹肌溶解症的预后良好。

Abstract

The clinical data of 3 patients with rhabdomyolysis (RM) caused by different viral infections were retrospectively reviewed. The diagnoses were established according to the clinical symptoms

physical signs

myocardial enzymes

and muscle biopsy. Case 1 was a 11-year-old boy with influenza A virus infection

whose major symptoms were fever

cough and myalgia. After the treatment of active anti-virus

hydration

and alkalinization

the patient completely recovered. Case 2 was a 10-year-old girl with Epstein-Barr (EB) virus infection who had significant musculoskeletal pain and muscle weakness symptoms with significantly elevated serum creatine kinase. After active hydration and anti-infective treatment

the patient’s condition returned to normal. Case 3 was a 15-year-old boy with human cytomegalovirus infection

whose symptoms were mainly repeated fever

accompanied by myalgia and facial edema. Antibacterial therapy was ineffective

and the disease progressed with respiratory muscle weakness and multiple organ injuries. After antiviral treatment

respiratory support and hemofiltration

the symptoms relieved and patient recovered without sequela. With literature review

we believe that although influenza virus

Epstein-Barr virus and cytomegalovirus rarely cause RM in children

it should be attached attention to. With early diagnosis and treatment

the prognosis is favorable.

关键词

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references

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