• 医学文献
  • 知识库
  • 评价分析
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
  • 临床诊疗知识库
  • 中医药知识库
  • 机构
  • 作者
热搜词:
换一批
论文 期刊
取消
高级检索

检索历史 清除

医学文献 >>
  • 全部
  • 中外期刊
  • 学位
  • 会议
  • 专利
  • 成果
  • 标准
  • 法规
知识库 >>
  • 临床诊疗知识库
  • 中医药知识库
评价分析 >>
  • 机构
  • 作者
热搜词:
换一批

他汀类药物相关肌病的临床和骨骼肌病理特点

The clinical and muscular pathological features of statin-induced myopathy

摘要:

目的 探讨他汀类药物相关肌病(简称他汀肌病)的临床特点及骨骼肌病理改变特点.方法 分析2012年4月至2014年10月就诊于北京大学第一医院并行肌肉活检的9例他汀肌病患者的临床及病理资料.结果 9例患者均口服他汀类药物4d至4年,就诊年龄55 ~74(63 ±6)岁,其中男6例,女3例.3例出现肌痛,6例出现四肢近端为主的肌无力,3例无任何临床症状.所有患者血清肌酸激酶(CK)升高(468 ~8 000 U/L).7例患者行血清肌炎抗体检查,均阴性.6例患者行肌电图检查,2例出现肌源性损害.6例患者行双侧大腿骨骼肌MRI检查,其中2例显示有部分肌群水肿及轻度脂肪化.骨骼肌活检病理主要表现:肌纤维萎缩、坏死、再生、脂肪滴增多,部分患者出现破碎蓝纤维、细胞色素c氧化酶阴性肌纤维及还原型辅酶Ⅰ四氮唑还原酶活性降低,主要组织相容性复合物-Ⅰ在肌纤维膜不同程度表达,补体C5b-9染色显示肌内衣、胞质以及毛细血管少量补体沉积.随访发现,多数(7例)患者停用他汀类药物或换用其他他汀类药物后,症状及CK水平改善,仅2例患者需应用免疫抑制治疗且有效.结论 本组患者中多数(7例)他汀肌病为自限性,停用他汀类药物后可自行好转,个别患者(2例)可出现免疫性坏死性肌肉病,需要应用免疫抑制治疗.

更多
abstracts:

Objective To explore clinical and muscular pathological features of statin-induced myopathy.Methods Nine patients were enrolled in this study,who were diagnosed as statin-induced myopathy by muscle biopsy in Peking University First Hospital from April,2012 to October,2014.The clinical data and pathological findings were analyzed.Results The exposure time to statins varied from 4 days to 4 years in the total of 9 patients,6 males and 3 females,with the average age of 63 ± 6 (55 to 74) years old.Three patients suffered from myalgia and 6 patients complained of weakness mainly at the proximal limbs,while no symptoms occured in 3 patients.Serum creatine kinase (CK) increased in all patients with the maximum value varied from 468 to 8 000 U/L.Serum myositis antibodies were tested in 7 patients and all were negative.Electromyogram was performed in six patients with myogenic damage found in 2 patients.MRI of bilateral thigh muscle was carried out in six patients with muscle edema and mild fatty infiltration found in 2 patients.All patients underwent skeletal muscle biopsy with histochemical and immunohistochemical staining.The main muscular pathological features were muscle fiber atrophy,necrosis,regeneration and increased lipid droplets.Ragged blue fiber,cytochrome C oxidase-negative muscle fibers and decreased NADH activity were observed in some patients.MHC-Ⅰ expressed in the sarcolemma of muscle fibers at various levels.Mild C5b-9 staining was found in the endomysium,capillary and cytoplasm.Symptoms and the level of CK were improved in 7 patients after discontinuing statins or changing to another statin,while the immunosuppressive therapy were used in 2 patients and shown to be effective.Conclusions Statin induced myopathy is self-limiting in most patients,with improvement after discontinuation of statins.Few patients with autoimmune necrotic myopathy need immunosuppressive therapy.

More
  • 浏览:511
  • 下载:481

加载中!

相似文献

  • 中文期刊
  • 外文期刊
  • 学位论文
  • 会议论文

加载中!

加载中!

加载中!

加载中!

扩展文献

特别提示:本网站仅提供医学学术资源服务,不销售任何药品和器械,有关药品和器械的销售信息,请查阅其他网站。

  • 客服热线:4000-115-888 转3 (周一至周五:8:00至17:00)

  • |
  • 客服邮箱:yiyao@wanfangdata.com.cn

  • 违法和不良信息举报电话:4000-115-888,举报邮箱:problem@wanfangdata.com.cn,举报专区

官方微信
万方医学小程序
new翻译 充值 订阅 收藏 移动端

官方微信

万方医学小程序

使用
帮助
Alternate Text
调查问卷