Liu Y, Cheng Z, Ding L, Fang F, Cheng K-A, Fang Q, Shi G-P
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Int J Clin Pharmacol Ther. 2010 Dec;48(12):798-802. doi: 10.5414/cpp48798.
Atorvastatin has been associated with liver injury. We reported here two cases of aminotransferases elevation within 12 h of low-dose atorvastatin therapy. Liver functions were fully recovered to the baseline level 11 days after discontinuation of atorvastatin treatment. The possible relative risk factors included advanced age, chronic and systemic diseases, and co-administration of cytochrome P450 3A (CYP3A) enzyme-dependent metabolic drugs or its inhibitors such as clopidogrel and diltiazem. No significant transaminase elevation was observed after switching to pravastatin. Thus, pravastatin might be safer than atorvastain in patients with chronic or systemic diseases, or with co-administration of CYP3A enzyme-dependent drugs.
阿托伐他汀与肝损伤有关。我们在此报告两例低剂量阿托伐他汀治疗12小时内出现转氨酶升高的病例。停用阿托伐他汀治疗11天后，肝功能完全恢复至基线水平。可能的相关危险因素包括高龄、慢性和全身性疾病，以及联合使用细胞色素P450 3A（CYP3A）酶依赖性代谢药物或其抑制剂，如氯吡格雷和地尔硫䓬。换用普伐他汀后未观察到明显的转氨酶升高。因此，对于患有慢性或全身性疾病，或联合使用CYP3A酶依赖性药物的患者，普伐他汀可能比阿托伐他汀更安全。
