阿托伐他汀钙片致OATP-SLCO1B1 C521T基因非突变患者横纹肌溶解  

Atorvastatin calcium tablets-induced rhabdomyolysis in a patient without OATP-SLCOIB1 C521T mutation

作　　者：母光妍 向倩[1] 胡琨[1] 崔一民[1] Mu Guangyan;Xiang Qian;Hu Kun;Cui Yimin(Department of Pharmacy,Peking University First Hospital,Beijing 100032,China)

机构地区：[1]北京大学第一医院药剂科,100032

出　　处：《药物不良反应杂志》2018年第5期376-377,共2页Adverse Drug Reactions Journal

基　　金：国家重点研发计划精准医学研究重点专项资助项目（2016YFC0904900）

摘　　要：1例55岁女性患者因高脂血症规律服用阿托伐他汀钙片20 mg，1次/d。2年后双小腿出现瘀斑伴胀痛、麻木，实验室检查示血清肌红蛋白682 μg/L、肌酸激酶1 007 U/L。同期患者未服用其他药物。考虑为阿托伐他汀钙片相关横纹肌溶解，停用该药，给予对症支持治疗。20 d后患者症状消失，血清肌红蛋白和肌酸激酶水平恢复正常。发生横纹肌溶解后行他汀类药物肌损伤相关有机阴离子转运多肽OATP的编码基因SLCO1B1 C521T检测，结果为TT型（非突变基因型），提示OATP-SLCO1B1 C521T基因型不能完全预测他汀类药物的肌毒性。A 55-year-old female patient with hyperlipemia received atorvastatin calcium tablets 20 mg, once daily orally. Two years later, the patient′s legs appeared ecchymosis with distending pain and numbness. Laboratory tests showed serum myoglobin 682 μg/L and creatine kinase 1 007 U/L. She had not received any other drugs during the same period. Atorvastatin-induced rhabdomyolysis was considered. Atorvastatin was stopped, and the patient received symptomatic and supportive treatment. Twenty days later, her symptoms disappeared and her serum myoglobin and creatine kinase level turned to normal. A gene test of SLCO1B1 C521T polymorphism of organic anion transporting polypeptides associated with statin-induced muscle injury was detected after rhabdomyolysis, and the result showed TT genotype （non-mutant genotype）. This suggested that the SLCO1B1 C521T genotypes could not predict the myotoxicity of statins accurately.

关 键 词：羟甲基戊二酰辅酶A还原酶抑制剂 横纹肌溶解 基因学 

分 类 号：R595.3[医药卫生—内科学]