肾功衰竭偶然是急性肌肉损伤的一种并发病,以往多归因于肌红蛋白尿。本文中提出了另外一种机制,即免疫复合物的沉淀导致了弥漫性肾小球病变。作者报道1例54岁妇女,患有肌肉疾病,最后全身麻痹以致死亡。在肌肉病变的过程中,并发肾功衰竭。病人在住病治疗期间未发现肌红蛋白尿,虽然在肾活检及尸检见肾小管内有一些色素物质,但并非广泛存在。肌肉活检显示严重肌炎,具有明显的坏死区、淀粉样变性、肌浆嗜硷性细胞增多和肌膜增厚等。未见到脉管炎变化。作者提到,多肌炎是一个原因不明的疾病,体液的、细胞的或病毒的因素可能是重要的。有些实验研究表明,细胞免疫过程在肌炎的发病中较 Renal failure is occasionally a complication of acute muscle injury, most of which was attributed to myoglobinuria. In this paper, another mechanism is proposed that the precipitation of immune complexes leads to diffuse glomerular lesions. The authors reported a 54-year-old woman who developed muscle disease and eventually died of general paralysis. In the process of muscle lesions, complicated by renal failure. Myoglobinuria was not observed during treatment of the patient, although there was some pigment in the renal tubules at the time of renal biopsy and necropsy but not extensively. Muscle biopsy showed severe myositis, with a clear necrosis area, amyloidosis, sarcoplasmic alkaloids and myometrial thickening and so on. Vasculitis was not seen. The authors note that polymyositis is an unexplained disease and that humoral, cellular or viral factors may be important. Some experimental studies have shown that the cellular immune process in the incidence of myositis more