他汀类药物相关肌病的临床特点分析

目的探讨他汀类药物相关肌病的临床表现及相关危险因素。方法对6例辛伐他汀相关肌病患者的临床特点、肌酶及肝肾功能改变进行回顾性分析。结果 6例患者平均年龄70岁,4例存在糖尿病。口服辛伐他汀2～4周出现乏力、肌痛症状,合并用其他调脂药5例。全部病例肌酸激酶不同程度升高,6例中5例出现转氨酶明显增高。甲状腺功能检查4例,3例存在亚临床甲减。停药2～4周后肌病症状及CK值基本恢复正常。结论乏力、肌痛是他汀类药物致肌病的主要临床症状,高龄、甲状腺功能减退、糖尿病、合并用其他调脂药可能增加肌病发生的风险,及时停药可恢复,预后良好。

Clinical characteristics of statin-associated myopathy

Objective To investigate the clinical characteristics and risk factors of statin-induced myopathy.Methods Six patients with statin-associated myopathy from April 2007 to December 2009 were retrospectively investigated to analyze the clinical symptoms and the changes in serum creatine kinase(CK)and hepatic and renal functions.Results The average age of 6 patients was 70.Four patients suffered diabetes complicatedly.All patients were treated with 40 mg simvastatin daily,five of them received combination therapy with niacin or ezetimibe.These patients felt weakness and myalgia after administration of simvastatin from two to four weeks.At the same time,the serum CK level of all patients was markedly elevated.Five patients had significantly higher alanine aminotransferase concentration.Three patients had subclinical hypothyroidism in 4 patients with thyroid function.The symptoms of myopathy and the serum CK level nearly recovered 2～4 weeks after drug withdrawal.Conclusion Weakness and myalgia were the main clinical symptoms of statins-associated myopathy.Elderly,hypothyroidism,diabetes and combination therapy with other lipid-lowering drugs may increase the risks of myopathy,but the prognosis is good after withdrawal of statins in time.