他汀类药物相关肌病临床和病理学研究  

Clinical and Pathological Features of Statins-Associated Myopathy

作　　者：朱天一 牛琦[2] 张平[3] 吴翔[4] 

机构地区：[1]江苏省南京市鼓楼区宁海路社区卫生服务站,210013 [2]南京医科大学第一附属医院神经科 [3]南京医科大学第二附属医院病理科 [4]南京医科大学第一附属医院心脏科

出　　处：《中华全科医学》2010年第12期1646-1647,F0003,共3页Chinese Journal of General Practice

基　　金：江苏省自然科学基金项目(BK2007607)

摘　　要：目的探讨他汀类药物相关肌病的临床表现和肌肉病理学特点。方法对1例他汀相关肌病患者进行临床、电生理、病理学和随访研究。结果患者为65岁女性,体重指数为20.9,因胆固醇升高服用辛伐他汀,1月后出现肌痛、肌无力症状,进行性加重。查血磷酸肌酸激酶(CK)为1522U/L;肌电图表为运动单位动作电位时限缩短及病理干扰相;左股四头肌活检示肌纤维灶状坏死,油红染色可见阳性纤维;透射电镜检查发现肌纤维内出现成串脂滴。立即停药并给予对症治疗。随访半年后,患者症状完全消失,CK恢复正常。结论该患者临床表现和电生理提示肌肉损害;病理学表现为肌纤维脂质代谢障碍的特点,符合他汀类相关肌病。老年女性患者使用他汀类药物时应注意监测其不良反应。Objective To investigate the clinical,muscular pathological features of statins-assoeiated myopathy. Methods Clinical feature, eleetrophysiology,muscular pathology and follow-up studies were conducted for a patient with statin-associated myopathy. Results The patient was a female in her 65 years old. BMI was 20.9. She had taken Simvastatin after diagnosed hypereholes- terolemia. She presented myodynia,musele weakness a month later. The serum CK level increased to 1 522 U/L. Eleetromyography study showed shortened duration of aetion potential and pathologic interference pattern. Left quadrieeps femoris＇ musele biopsy presented focal neerosis and positive of oil red O staining. Transmission electron microscope examination found lipid droplets lining up in the muscular fibers. Withdrawing the drug immediately and following-up for half a year, the symptoms disappeared completely and CK level reduced to normal. Conclusion The clinic and EMG features of the patient demonstrated lesions of muscle. Pathology showed abnormal lipid metabolism in muscle fibers. These characters accorded with statins-assoeiated myopathy. Side effeets should be monitored when old female took statins.

关 键 词：他汀类相关肌病 肌肉活检 肌肉病理学 

分 类 号：R994.11[医药卫生—毒理学] R972.6[医药卫生—药学]