糖尿病患者应用他汀药物致肌病8例报告

Statin-induced myopathy in diabetes patients:a report of 8 cases

目的分析糖尿病患者应用他汀药物出现肌病的临床特点及发生原因。方法回顾性分析8例糖尿病患者应用他汀类药物致肌病的临床资料,并进行相关文献复习。结果 8例患者均有肌肉酸痛,其中5例肌酸激酶(CK)升高。2例诊断为横纹肌溶解症,3例为肌炎,3例为较轻肌痛。引起肌病的药物主要为辛伐他汀、阿托伐他汀,1例为阿托伐他汀联用非诺贝特引起横纹肌溶解症,1例为氟伐他汀引起肌痛。2例横纹肌溶解病人合并多种疾病及多种合并用药。结论糖尿病患者尤其合并多种基础疾病及合并用药多的患者在应用他汀类药物时要严密观察临床症状及生化指标检测。

Objective To investigate the clinical features and pathogenesis of statin-induced myopathy in diabetic patients.Methods The medical records of eight diabetic patients with statin-induced myopathy were analyzed and the related literatures were reviewed.Results All the patients experienced myalgia.Serum level of creatine kinases（CK） increased in five patients.Two patients were diagnosed rhabdomyolysis,three patients had myositis and three patients only had mild myalgia.Myopathy was mainly caused by simvastatin and atorvastatin.One patient experienced rhabdomyolysis caused by combined use of simvastatin and fenofibrate.One patient with myalgia was induced by fluvastatin.Two patients with rhabdomyolysis were complicated with various diseases and combined medication.Conclusion Clinical manifestations and biochemical indicators should be closely monitored in the diabetic patients after administration with statins,especially in patients complicated with various diseases and the combined medication.