类固醇肌病一例及文献复习  

Steroid-induced Disease: A Case Report and the Literatures Review

作　　者：李金虹[1] 邓倩[1] 张永志[1] 陈芹[1] 

机构地区：[1]四川大学华西医院神经内科,成都610041

出　　处：《华西医学》2016年第2期216-219,共4页West China Medical Journal

基　　金：国家自然科学基金(81201009)~~

摘　　要：目的探讨激素药物致类固醇肌病的发病特点、发病机制及治疗措施。方法对2015年10月20日入院治疗的1例使用激素致类固醇肌病患者的临床资料进行回顾性分析。结果患者因"左下肢疼痛伴萎缩20年,复发伴四肢肌肉萎缩6个月"入院。既往诊断为"坐骨神经痛"后患者私自滥用激素(曲安奈德)治疗后出现四肢肌肉乏力、萎缩,四肢近端肌力5-级,肌酸激酶53 U/L,神经肌电图检查提示四肢神经源性损害,考虑类固醇肌病,立即停用激素,后患者症状逐渐好转。结论类固醇肌病发病与糖皮质激素滥用密切相关,规范使用激素并及时发现激素使用的并发症类固醇肌病,并停用糖皮质激素,是避免发病和改善预后最重要的措施。Objective To investigate the characteristics, pathogenesis and treatment of steroid-induced diseases. Methods The clinical data of one patient with steroid-induced disease diagnosed and treated on October 20 th, 2015 were analyzed retrospectively. Results This patient was admitted to the hospital because of ＂20 years of pain in the left lower limb and 6 months after the recurrence of the muscle atrophy＂. After previous diagnosis of sciatica, the patient abused hormone therapy（triamcinolone）, and had limb muscle weakness, atrophy, proximal limb muscle strength of grade 5-, creatine kinase 53 U/L, and electromyography suggested neurogenic damage of the limbs. We considered steroid myopathy, and required immediate stop of hormone. The patient＇s symptoms gradually improved. ConclusionsSteroid myopathy and the pathogenesis of glucocorticoid abuse are closely related. Regulating the use of hormone, timely detection of complication of steroid myopathy and stopping the use of sugar cortical hormone are the most important measures to avoid the disease and improve the prognosis.

关 键 词：曲安奈德 糖皮质激素类 肌疾病 

分 类 号：R746[医药卫生—神经病学与精神病学]