慢性类固醇肌病(附1例报告及文献复习)  

Chronic Steroid Myopathy:One Case Report and Literature Review

作　　者：段宝京 蔡爽 周磊 刘珏 朱雯华 赵重波 卢家红 董占军[1] D UAN Bao-Jing;CAI Shuang;ZHOU Lei;LIU Jue;ZHU Wen-Hua;ZHAO Chong-Bo;LU Jia-Hong;DONG Zhan-Jun(Department of Pharmacy, Hebei General Hospital, Shijiazhuang 050051, China;Department of Neurology, Huashan Hosptial, Fudan University, Shanghai 200040, China;Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai 200040, China)

机构地区：[1]河北省人民医院药学部,石家庄050051 [2]复旦大学附属华山医院神经内科,上海200040 [3]复旦大学附属华山医院药剂科,上海200040

出　　处：《中国临床神经科学》2018年第3期294-300,共7页Chinese Journal of Clinical Neurosciences

摘　　要：目的报道1例糖皮质激素致慢性类固醇肌病的病例,探讨患者发生慢性类固醇肌病的原因。方法回顾性收集1例使用糖皮质激素致慢性类固醇肌病患者的临床资料,并进行文献分析。结果患者自7年前诊断为系统性红斑狼疮后开始应用糖皮质激素治疗,2017年5月诊断狼疮性肾病,行环磷酰胺和糖皮质激素冲击治疗后患者逐渐出现下肢乏力、肌肉萎缩,完善检查后诊断为慢性类固醇肌病,建议患者就诊风湿免疫科调整治疗方案,尽量减少糖皮质激素用量。结论慢性类固醇肌病发病与糖皮质激素的应用剂量无明确相关性,糖皮质激素与环磷酰胺同时应用可能会使糖皮质激素的代谢受到抑制,糖皮质激素相关不良反应也更易发生,但仍需临床研究进一步确证。Aim To report a case of steroid myopathy caused by glucocorticoid and explore the reason of steroid myopathy.Methods The clinical data of a steroid myopathy patient using glucocorticoid was collected and the related literature was analyzed.Results Seven years ago the patient was diagnosed with systemic lupus erythematosus and began to be treated with glucocorticoid.And she was diagnosed with lupus nephritis in May 2017.After being treated with cyclophosphamide and glucocorticoid pulse,lower extremity weakness and muscular atrophy occurred,and then the patient was diagnosed with steroid myopathy after further examination.The patient was recommended to visit the department of rheumatology and decrease the dose of glucocorticoid.Conclusion The incidence of chronic steroid myopathy and glucocorticoid dose has no dear correlation.Simultaneous use of glucocorticoid and cyclophosphamide may inhibit the glucocorticoid metabolism and glucocorticoid-related adverse reactions may be more likely to occur,but further clinical studies are still needed.

关 键 词：类固醇肌病 慢性 肌病 糖皮质激素 环磷酰胺 

分 类 号：R746[医药卫生—神经病学与精神病学]