Phillips Paul S, Haas Richard H, Bannykh Sergei, Hathaway Stephanie, Gray Nancy L, Kimura Bruce J, Vladutiu Georgirene D, England John D F
Interventional Cardiology, Scripps Mercy Hospital and University of California, San Diego, Medical Center, San Diego, California 92103, USA.
Ann Intern Med. 2002 Oct 1;137(7):581-5. doi: 10.7326/0003-4819-137-7-200210010-00009.
Muscle symptoms in patients who are treated with statins and have normal creatine kinase levels are not well understood.
To report biopsy-confirmed myopathy and normal creatine kinase levels associated with statin use.
Case reports from preliminary analysis of an ongoing clinical trial.
Clinical research center in a community hospital.
Four patients with muscle symptoms that developed during statin therapy and reversed during placebo use.
All four patients repeatedly distinguished blinded statin therapy from placebo. Strength testing confirmed weakness during statin therapy that reversed during placebo use. Muscle biopsies showed evidence of mitochondrial dysfunction, including abnormally increased lipid stores, fibers that did not stain for cytochrome oxidase activity, and ragged red fibers. These findings reversed in the three patients who had repeated biopsy when they were not receiving statins. Creatine kinase levels were normal in all four patients despite the presence of significant myopathy.
Some patients who develop muscle symptoms while receiving statin therapy have demonstrable weakness and histopathologic findings of myopathy despite normal serum creatine kinase levels.
对于接受他汀类药物治疗且肌酸激酶水平正常的患者出现的肌肉症状，目前尚未完全了解。
报告经活检证实的与他汀类药物使用相关的肌病及正常肌酸激酶水平。
来自一项正在进行的临床试验初步分析的病例报告。
一家社区医院的临床研究中心。
4例在他汀类药物治疗期间出现肌肉症状且在使用安慰剂期间症状缓解的患者。
1）患者辨别盲法他汀类药物治疗的能力；2）功能能力和肌肉力量的标准测量指标。
所有4例患者均能反复区分盲法他汀类药物治疗和安慰剂。力量测试证实他汀类药物治疗期间出现肌无力，而在使用安慰剂期间肌无力症状缓解。肌肉活检显示线粒体功能障碍的证据，包括脂质储存异常增加、细胞色素氧化酶活性染色阴性的纤维以及破碎红纤维。在3例接受重复活检的患者中，当他们未接受他汀类药物治疗时，这些发现有所逆转。尽管存在明显的肌病，但所有4例患者的肌酸激酶水平均正常。
一些在接受他汀类药物治疗时出现肌肉症状的患者，尽管血清肌酸激酶水平正常，但仍有明显的肌无力和肌病的组织病理学表现。
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