Banga J D
Universitair Medisch Centrum Utrecht, afd. Interne Geneeskunde, Postbus 85.500, 3508 GA Utrecht.
Ned Tijdschr Geneeskd. 2001 Dec 8;145(49):2371-6.
Rhabdomyolysis is a rare but potentially fatal complication associated with the use of cholesterol synthesis inhibitors (statins). The complication can develop in susceptible patients and with the concomitant use of medications that impede the biodegradation of statins, for example, biotransformation via the cytochrome P450 system. This may result in the plasma and tissue concentrations of statins, and their active metabolites, increasing to levels that are toxic for striated muscle. Myopathy is present when plasma activity levels of creatinine kinase are raised to in excess of 10 times the upper limit of the normal value. Muscular complaints which may be indicative of myotoxicity and subsequent myopathy are present in 1-7% of statin users. Albeit to varying degrees, all statins can induce myotoxicity especially at high dosages. Rhabdomyolysis was clearly more prevalent under cerivastatin users than the users of other statins and was therefore recently withdrawn from the market. Statins should be withdrawn immediately if myopathy is suspected. Prompt withdrawal may prevent rhabdomyolysis.
横纹肌溶解症是一种与使用胆固醇合成抑制剂（他汀类药物）相关的罕见但可能致命的并发症。该并发症可在易感患者中发生，并且在同时使用阻碍他汀类药物生物降解的药物时出现，例如通过细胞色素P450系统进行的生物转化。这可能导致他汀类药物及其活性代谢产物的血浆和组织浓度升高至对横纹肌有毒的水平。当肌酐激酶的血浆活性水平升高至超过正常值上限的10倍时，即存在肌病。在1%至7%的他汀类药物使用者中存在可能提示肌毒性及随后肌病的肌肉症状。尽管程度不同，但所有他汀类药物都可诱发肌毒性，尤其是在高剂量时。与其他他汀类药物使用者相比，西立伐他汀使用者中横纹肌溶解症显然更为普遍，因此该药物最近已退出市场。如果怀疑有肌病，应立即停用他汀类药物。及时停药可能预防横纹肌溶解症。
