在ICU获得的肌肉衰弱中的神经生理学和肌肉组织病理学:从COVID-19中吸取的教训
Eva K Hejbøl1, Atle V Lomstein2, Henrik D Schrøder1,3
1Department of Pathology, Odense University Hospital, Odense, Denmark.
Clinical neurophysiology practice
|June 9, 2025
概括
严重的COVID-19可以导致重症监护室获得的软弱 (ICUAW) 与多种肌肉病理,包括严重疾病肌肉病变 (CIM),炎症肌肉病变和线粒体功能障碍,尽管临床表现相似.
科学领域:
- 神经学 神经学
- 病理学 病理学 病理学
- 关键护理医学 关键护理医学
背景情况:
- 与COVID-19相关的重症监护病房获得的弱点 (ICUAW) 是一个重大的临床挑战.
- 了解潜在的肌肉病理对于患者的管理和预后至关重要.
研究的目的:
- 描述COVID-19相关ICUAW中的肌肉病理的电生理学,组织病理学和超结构性模式.
- 为了调查COVID-19相关的严重疾病肌肉病变 (CIM) 是否是一个独特的实体,还是与其他原因的CIM相似.
主要方法:
- 三名COVID-19相关的ICUAW患者的系统报告.
- 使用临床检查,电生理学测试和肌肉病理学 (光和电子显微镜).
主要成果:
- 所有患者都表现出严重的近端和远端虚弱,肌肉酶升高和肌病性电肌图.
- 肌肉病理学揭示了各种各样的发现:一种是CIM,另一种是严重的炎症性肌肉病变,第三种是线粒体变化.
- 两名患者表现出炎症性肌肉病症的电生理学迹象,具有缩活性.
结论:
- 尽管临床和电生理学模式相似,但COVID-19相关的ICUAW中的肌肉病理是多样化的.
- 该频谱包括危急性疾病肌肉病变 (CIM),自身免疫反应和线粒体功能障碍.
- 电生理学和组织病理学对于确定病因,指导治疗和预测预后至关重要.
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