阿托伐他汀不良反应的流行病学特征研究简

目的探讨阿托伐他汀不良反应的流行病学特点，为临床安全用药提供参考。方法以阿托伐他汀、立普妥、阿托伐他等为检索词，检索中国医院知识仓库（CHKD）和万方数据库收录的2000年至2012年所有中文文献。阅读、筛选所有描述阿托伐他汀不良反应的文献资料，并进行统计、分析。结果共检索报道阿托伐他汀不良反应文献53篇，收集病例53例。男性患者是女性患者的2．8倍，其发生率随年龄增加而增高，60岁以上占52．83％。不良反应损害主要以消化系统和骨骼肌肉系统为主，构成比分别为43．40％和32．08％，临床主要表现为转氨酶升高、药物性肝炎，肌痛、关节痛及横纹肌溶解症。88．69％的病例不良反应发生在用药后30d内，特别是用药后1周内。阿托伐他汀不良反应一般转归良好，但在高龄患者中，横纹肌溶解症可造成严重后果。结论阿托找他汀的不良反应发生率与性别、年龄相关联，在高龄人群中其不良反应可产生致命后果。开始用药后30d内，应密切观察患者用药后出现的不适症状，并进行生化检查，以保证用药安全。

Epidemiological Characteristics of Adverse Reactions of Atorvastatin

Objective To investigate the epidemiological characteristics of adverse drug reactions （ADR） induced by atorvastatin in order to provide references for its safe clinical application. Methods The whole Chinese literatures included in the Chinese Hospital Knowledge Database （CHKD） and the Wangfang data from 2000 to 2012 were retrieved with atorvastatin, lipitor, ADR, etc. as the index words. All literatures describing ADR of atorvastatin were reviewed and screened for statistical analysis. Results Fifty- three articles re- porting ADR of atorvastatin were retrieved and total 53 cases of ADR were collected. The male patients was 2.8 times of the female patients. The occurrence rate atorvastatin- induced ADR was increased with age increase and the patients aged more than 60 years old accounted for 52. 83%. The lesions of ADR involved primarily in digestive system and musculoskeletal system with the constituent ratio of 43.40% and 32. 08%, respectively. The clinical manifestations included the elevation in ALT, drug-induced hepatitis, muscle pain, joint pain and rhabdomyolysis. Majority（88.69% ） of atorvastatin-related adverse events occurred within 30 d, particularly within 7 d after administration. Generally, the prognosis of adverse events was good, but in elderly patients rhabdomyolysis would cause severe consequence. Conclusion The occurrence rate of atorvastatin- induced ADR is associated with sex and age. In elderly patients ADR can lead to deadly consequence. For ensuring the medication safety, any discomfortable symptoms should be closely observed and neces- sary biochemical detection should he performed within 30 d after administration.