Heuer T, Gerards H, Pauw M, Gabbert H E, Reis H E
Medizinische Klinik I, Krankenhaus Maria Hilf, Mönchengladbach.
Med Klin (Munich). 2000 Nov 15;95(11):642-4. doi: 10.1007/pl00002078.
We report on 4 patients who were referred to the clinic with suspected acute hepatitis and to investigate high transaminase values. After exclusion of specific hepatitis, unspecific virus hepatitis, autoimmune hepatitis, a metabolic disorder damaging the liver and extrahepatic cholestasis, a toxic liver damage remained as the probable cause and was histologically verified. Since other drugs and alcoholics could be eliminated as possible causes of the damage, the toxicity had to be attributed to statin ingestion.
After discontinuation of the medication with continuation of all other therapeutic agents of the general practitioners, the transaminase values normalized within a few weeks. Renewed administration of statin was not prescribed for ethical reasons.
Therefore, when prescribing a HMG-CoA-reductase inhibitor, the possibility of liver damage should be mentioned and regular checks of the transaminase values should be performed.
我们报告了4例因疑似急性肝炎被转诊至诊所并调查高转氨酶值的患者。在排除了特定肝炎、非特异性病毒性肝炎、自身免疫性肝炎、损害肝脏的代谢紊乱以及肝外胆汁淤积后,毒性肝损伤仍被视为可能的病因,并经组织学证实。由于其他药物和酒精可被排除为可能的损伤原因,毒性必须归因于他汀类药物的摄入。
在停用该药物并继续使用全科医生的所有其他治疗药物后,转氨酶值在几周内恢复正常。出于伦理原因,未再次开具他汀类药物。
因此,在开具HMG-CoA还原酶抑制剂时,应提及肝损伤的可能性,并定期检查转氨酶值。