摘要
目的探讨调脂药物引起横纹肌溶解综合征(RM)的临床特征。方法回顾性分析10例调脂药所致RM患者的临床特征及诊治经过。结果10例患者中单用他汀类者4例,单用贝特类者4例,两药联用者2例,RM发生于起始或调整调脂治疗1~8(4±2.7)周。患者合并症包括动脉粥样硬化性心血管疾病、肾衰竭、糖尿病、高血压、甲状腺功能减退症及多发性肌炎。症状以肌痛最为常见,仅有1例同时具备RM三联征(肌痛、肌无力、茶色尿),尚有1例无RM症状。4例患者出现急性肾损伤,所有患者均停用调脂药物并接受补液、碱化尿液等治疗,4例患者加用持续肾脏替代治疗。所有患者均治愈。结论多种调脂药物可引起RM,临床表现多样,多数患者治疗后预后良好。合并症及合并用药有可能增加调脂药物相关RM风险,临床医师应提高警惕。
Objective To explore the clinical characteristics of rhabdomyolysis(RM)caused by lipid-lowering drugs.Methods The clinical characteristics,diagnosis and treatment of 10 patients with lipid-lowering drugs induced RM were retrospectively analyzed.Results Among the 10 patients,4 were treated with statins alone,4 were treated with fibrates alone,and the other 2 were treated with statins and fibrates.RM occurred during 1 to 8(4±2.7)weeks since the initiation or adjustment of lipid-lowering therapy.Common comorbidities included atherosclerotic cardiovascular disease,renal failure,diabetes,hypertension and polymyositis.The most common symptom was myalgia.Only one patient showed RM triad(myalgia,myasthenia,and brown urine),and another patient was asymptomatic,while 4 patients developed acute kidney injury.Lipid-lowering drugs were discontinued in all the patients with fluid replacement and alkalization of urine were applied,and 4 patients received continuous renal replacement therapy.All patients recovered.Conclusion Many lipid-lowering drugs can cause RM,whose clinical manifestations are diverse,and the prognosis is good.Comorbidities and concomitant medication may increase the risk of lipid-lowering drug related RM so clinicians should be alerted.
作者
高楚淇
孙荣欣
单媛媛
王金龙
陈蕾
李昊
施秉银
强薇
GAO Chu-qi;SUN Rong-xin;SHAN Yuan-yuan;WANG Jin-long;CHEN Lei;LI Hao;SHI Bing-yin;QIANG Wei(Department of Endocrinology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Beijing Key Laboratory of Diabetes Research and Care,Center for Endocrine Metabolism and Immune Diseases,Luhe Hospital,Capital Medical University,Beijing 101149;Department of Pharmacy,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Blood Purification,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Critical Care Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061)
出处
《中南药学》
CAS
2020年第9期1584-1590,共7页
Central South Pharmacy
基金
国家自然科学基金青年科学基金(No.81802829)
陕西省自然科学基础研究项目(No.2020JQ-501)。
