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他汀类药物相关横纹肌溶解症伴急性肾衰竭并发透析内非 ST 段抬高型心肌梗死:脂质管理注意事项综述。

Statin-associated rhabdomyolysis with acute renal failure complicated by intradialytic NSTEMI: a review of lipid management considerations.

机构信息

Department of Cardiology, Harry S Truman Memorial Veterans' Hospital, Columbia, MO, USA.

出版信息

Am J Ther. 2013 Jan;20(1):57-60. doi: 10.1097/MJT.0b013e3181ff7c79.

Abstract

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are associated with myopathy, myalgias, myositis, and rhabdomyolysis. Rhabdoymyolysis is a rare complication and may cause acute renal failure, which may be fatal. In such cases, alternative therapies should be considered. In this review, we attempted to elucidate the lipid management options in patients with rhabdomyolysis and coronary artery disease. We also describe a case report of a patient who developed rhabdomyolysis from dual antilipid therapy followed by acute renal failure and non-ST elevation myocardial infarction. Such a complex case has not been reported in the literature, and lipid management options may include niacin, omega 3-fatty acids, or bile acid sequestrants. Once alternative therapies are initiated, monitoring a patient closely with evaluation for associated adverse events should be performed.

摘要

他汀类药物(3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂)与肌病、肌痛、肌炎和横纹肌溶解有关。横纹肌溶解是一种罕见的并发症,可能导致急性肾衰竭,这可能是致命的。在这种情况下,应考虑替代疗法。在本综述中,我们试图阐明横纹肌溶解症和冠心病患者的血脂管理选择。我们还描述了一例患者的病例报告,该患者因双重抗脂治疗后发生横纹肌溶解症,继而发生急性肾衰竭和非 ST 段抬高型心肌梗死。这种复杂的病例在文献中尚未报道,血脂管理选择可能包括烟酸、欧米伽 3 脂肪酸或胆汁酸螯合剂。一旦开始替代疗法,就应密切监测患者,并评估相关不良反应。

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