他汀类药物的临床应用及不良反应研究进展

Clinical application of statins and their major adverse effects

他汀类药物是一线降脂药物,也是心血管疾病的预防药物,临床应用和研究范围正不断扩大。他汀类药物临床应用研究主要关注心血管疾病一级预防、充血性心力衰竭的治疗、对糖尿病发病的影响等。近年来,他汀类药物的不良反应,特别是肝毒性和肌毒性也愈发引起人们的关注。肝毒性主要表现为转氨酶升高,严重者引起肝功能衰竭;肌毒性主要表现为肌痛、抽搐等,严重者会引起横纹肌溶解症。临床上主要采用监测血清丙氨酸转氨酶或磷酸肌酸激酶,结合临床表现并及时减量或停药的方法来防止严重不良反应的发生,一些新的治疗方案还在研究中。深入研究他汀类药物不良反应的发生机制,开发有效的辅助治疗方法或复方药物有助于该类药物的安全应用。

Statins, the first-line lipid-lowering agents, are also used as the secondary prevention drugs for cardiovascular disease. The excellent curative effects on hyperlipidemia-associated cardiovascular diseases have expanded the scope of their clinical application. Currently, the research direction on the clinical applications of statins involves primary prevention of cardiovascular disease, congestive heart failure treatment, the impact on the incidence of diabetes, etc. However, the side effects of statins, especially liver and muscle toxicity, have increasingly aroused people＇s attention. The main symptom of hepatotoxicity is the elevated level of blood se- rum aminotransferase, and in very few severe cases it can lead to liver failure. The main symptoms of myotoxicity are myalgia, muscle weakness, or even rhabdomyolysis. In clinics, severe adverse effects are prevented by decreasing the dosage or terminating statin therapy. Further study on the mechanisms of adverse effects of statins and development effective adjuvant therapies or combination prescrip- tions would be beneficial for using statins safely and effectively.