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[一名使用雄激素同化类固醇的年轻男性发生急性心肌梗死]

[Acute myocardial infarction in a young man who had been using androgenic anabolic steroids].

作者信息

Halvorsen Sigrun, Thorsby Per M, Haug Egil

机构信息

Hjerte-Lungesenteret, Ullevål universitetssykehus, 0407 Oslo.

出版信息

Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):170-2.

Abstract

BACKGROUND

A few case reports suggest that the use of androgenic anabolic steroids may be associated with myocardial infarction.

MATERIAL AND METHODS

Case report.

RESULTS

We report the case of a 27-year-old male body builder with acute myocardial infarction due to occlusion of the proximal left anterior descending coronary artery. He was treated with primary angioplasty with stent implantation and intra-aortic balloon support, but still developed a large myocardial infarction as determined by both echocardiography and myocardial perfusion tomography. The patient had been using androgenic anabolic steroids regularly for ten years. There was no family history of heart disease or lipid disorder.

INTERPRETATION

The actual frequency of myocardial infarction and even sudden death among users of anabolic steroids is presumably underreported in the medical literature. A causal relationship is not established, but a pathogenic role is plausible. Use of androgenic anabolic steroids has been associated with platelet hyperactivity, effects on vasoreactivity and changes in lipid levels. It is important for clinicians to be aware of this association and to counsel patients carefully about this and other side effects that may occur with these agents.

摘要

背景

一些病例报告表明,使用雄激素类合成代谢类固醇可能与心肌梗死有关。

材料与方法

病例报告。

结果

我们报告一例27岁男性健美运动员,因左前降支冠状动脉近端闭塞发生急性心肌梗死。他接受了支架植入的直接血管成形术和主动脉内球囊支持治疗,但经超声心动图和心肌灌注断层扫描确定仍发生了大面积心肌梗死。该患者已规律使用雄激素类合成代谢类固醇十年。无心脏病或脂质紊乱家族史。

解读

医学文献中可能未充分报道合成代谢类固醇使用者中心肌梗死甚至猝死的实际发生率。因果关系尚未确立,但致病作用似乎是合理的。使用雄激素类合成代谢类固醇与血小板活性过高、对血管反应性的影响以及脂质水平变化有关。临床医生了解这种关联并就这些药物可能出现的此类及其他副作用向患者进行仔细咨询非常重要。

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