他汀不耐受的临床诊断与处理中国专家共识

Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients With Statin Intolerance

他汀不耐受是指患者服用他汀类药物后出现一种或多种他汀类药物相关不良反应,减量或停用他汀类药物可改善,重启后再次出现的临床现象。他汀不耐受的相关报道并非少见,但真实世界中他汀不耐受的临床诊断与处理存在一定的困惑或误区,包括缺乏统一的定义和诊断标准、诊断的把握度偏宽、处理策略欠科学等问题,这在一定程度上阻碍了他汀类药物的科学、合理地使用。据此,本共识全面复习全球他汀不耐受相关研究数据,参考国外他汀不耐受相关指南与共识,提出适合我国人群的他汀不耐受的基本定义,并推荐相应的诊断标准及处理策略,以期改善我国人群他汀类药物的临床应用现状,进而提高动脉粥样硬化性心血管疾病的防治水平。

Statin intolerance refers to a clinical phenomenon in which patients experienced one or more statin related adverse reactions after taking statins,which can be improved by reducing or stopping statin treatment,but symptoms then reappear after restarting statin medication.Statin intolerance cases are not uncommon,but there are certain confusions or misconceptions in the clinical diagnosis and management in the real world,including the lack of unified definitions and diagnostic standards,broad grasp of diagnosis and unscientific management strategies,which might hinder the scientific and rational use of statins to some extent.Based on that,this consensus comprehensively reviewed global research data on statin intolerance,referenced guidelines and consensus literature on statin intolerance in foreign countries and different regions,proposed the statin intolerance definition suitable for the Chinese population,and recommended corresponding diagnostic criteria and management strategies,aiming to improve the clinical application of statin medications and enhance the prevention and treatment level of atherosclerotic cardiovascular disease in China.