321例药源性横纹肌溶解症分析  

Analysis of 321 cases of drug-induced rhabdomyolysis

作　　者：马晓菲[1] 刘星辰[1] MA Xiao-fei;LIU Xing-chen(Nanlou Pharmacy, Department of Pharmacy, PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院药学部南楼药房,北京100853

出　　处：《中国药物应用与监测》2019年第1期29-31,35,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的:探讨各类药物引起药源性横纹肌溶解症(RL)的临床症状、发病人群分布等,为临床合理用药提供数据参考。方法:检索中国知网数据库2000年–2018年有关药源性RL的报道,对符合标准的101篇文献中321例有关药源性RL的患病人群分布、临床特征进行统计学分析。结果:321例药源性RL病例中男女比例为1.10∶1;根据年龄段细分,60～70岁发病率最高(83例,25.86%);用药后出现RL时间最短为10 h,最长在用药2年出现RL;275例(85.67%)为用药1个月内出现RL;药物种类分布方面以他汀类药物最高,其次是苯氧酸衍生物类;并发症和转归情况,共计出现114例并发症,1例多器官衰竭死亡。结论:建议临床应重点观注使用他汀类和苯氧酸衍生物类药物的中老年患者的肌酸激酶(CK)含量,一旦CK含量异常应立即采取积极治疗措施,以防止肝肾功能的损害。Objective: To investigate the clinical symptoms and population distribution of drug-induced rhabdomyolysis (RL) caused by various drugs, and provide references for rational drug use in clinic. Methods: The literature reports on druginduced RL in CNKI database from 2000 to 2018 were searched. The population distribution and clinical features of 321 patients with drug-induced RL were statistically analyzed from 101 articles that met the criteria. Results: In the 321 cases of drug-induced RL, male to female ratio was 1.10 : 1. According to the age segment, the highest incidence rate was in the group of 60 to 70 years old (83 cases, 25.86%). The shortest time of RL occurrence after administration of suspected drug was 10 h, while the longest time was 2 years. About 275 cases (85.67%) developed RL within 1 month of drug use. As for the drug type distribution, statins were the most drugs which induced RL, followed by the phenoxy acid derivatives. Complications and outcomes were as follow. There were a total of 114 cases of complication, and 1 case was dead because of multiple organ failure. Conclusion: The clinical monitoring of creatine kinase (CK) content should be enhanced in middle-aged and elderly patients with statins and phenoxy acid derivatives. Once abnormal CK content was found, the treatment measures must be taken immediately to prevent liver and kidney damage.

关 键 词：药源性横纹肌溶解症 肌酸激酶 药品不良反应 统计分析 

分 类 号：R969.3[医药卫生—药理学]