苯扎贝特致横纹肌溶解症  

Rhabdomyolysis induced by bezafibrate

作　　者：龚俊艳 赵波 李若男 艾金伟 周兴建 Gong Junyan;Zhao Bo;Li Ruonan;Ai Jinwei;Zhou Xingjian(Department of Endocrinology,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Hubei Province,Xiangyang 441000,China;Department of Geriatrics,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Hubei Province,Xiangyang 441000,China;Department of Orthopedics No.3,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Hubei Province,Xiangyang 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院内分泌科,襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院老年病科,襄阳441000 [3]湖北医药学院附属襄阳市第一人民医院骨三科,襄阳441000

出　　处：《药物不良反应杂志》2021年第12期668-670,共3页Adverse Drug Reactions Journal

摘　　要：1例55岁女性患者因2型糖尿病和高血压病等间断服用阿卡波糖、贝那普利和苯磺酸左氨氯地平,规律服用阿司匹林肠溶片及阿托伐他汀钙,改为苯扎贝特降脂及甘舒霖30R降糖(其他治疗不变)后7 d患者出现双下肢肌肉酸痛和浓茶色尿液,实验室检查示天冬氨酸转氨酶(AST)213 U/L,肌酸激酶(CK)8655 U/L,CK‑MB 555 U/L、乳酸脱氢酶(LDH)579 U/L,α‑羟丁酸脱氢酶(α‑HBDH)505 U/L,肌红蛋白(MYO)135μg/L。考虑为横纹肌溶解症,可能与苯扎贝特有关。停用该药,嘱患者多饮水、勤排尿,同时予补液、碱化尿液、保肝、护肾等对症支持治疗。停药11 d后,患者肌肉酸痛症状缓解,尿液颜色变浅,实验室检查示CK 105 U/L,MYO 119μg/L;停药18 d后,患者肌肉酸痛消失,尿液颜色恢复正常,实验室检查示AST 37 U/L,CK 75 U/L,CK‑MB 45 U/L,MYO 75μg/L,LDH 241 U/L。A 55‑year‑old female patient took acarbose,benazepril,and levamlodipine besylate intermittently and aspirin enteric‑coated tablets and atorvastatin calcium regularly due to type 2 diabetes mellitus and hypertension,etc.After changing to bezafibrate for lipid‑lowering and Gansulin 30R for glucose lowering(other treatments continued),the patient developed muscle soreness of both lower limbs and dark brown urine 7 days later.Laboratory tests showed aspartate aminotransferase(AST)213 U/L,creatine kinase(CK)8655 U/L,CK‑MB 555 U/L,lactate dehydrogenase(LDH)579 U/L,α‑hydroxybutyrate dehydrogenase(α‑HBDH)505 U/L,and myoglobin(MYO)135μg/L.Rhabdomyolysis was considered,which might be related to bezafibrate.Then bezafibrate was stopped.The patient was asked to drink plenty of water and urinate frequently,and the symptomatic and supportive treatments such as rehydration,alkalization of urine,liver protection,and kidney protection were given.After 11 days of drug withdrawal,her symptom of muscle soreness was relieved and the color of urine became lighter;laboratory tests showed CK 105 U/L and MYO 119μg/L.After 18 days of drug withdrawal,the patient′s myalgia disappeared,urine color returned to normal;laboratory tests showed AST 37 U/L,CK 75 U/L,CK‑MB 45 U/L,MYO 75μg/L,and LDH 241 U/L.

关 键 词：苯扎贝特 横纹肌溶解 病例报告 

分 类 号：R969[医药卫生—药理学]