Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, PL 20-954 Lublin, Poland.
Pharmacol Rep. 2011;63(4):859-66. doi: 10.1016/s1734-1140(11)70601-6.
Statins are considered to be safe, well tolerated and the most efficient drugs for the treatment of hypercholesterolemia, one of the main risk factor for atherosclerosis, and therefore they are frequently prescribed medications. The most severe adverse effect of statins is myotoxicity, in the form of myopathy, myalgia, myositis or rhabdomyolysis. Clinical trials commonly define statin toxicity as myalgia or muscle weakness with creatine kinase (CK) levels greater than 10 times the normal upper limit. Rhabdomyolysis is the most severe adverse effect of statins, which may result in acute renal failure, disseminated intravascular coagulation and death. The exact pathophysiology of statin-induced myopathy is not fully known. Multiple pathophysiological mechanisms may contribute to statin myotoxicity. This review focuses on a number of them. The prevention of statin-related myopathy involves using the lowest statin dose required to achieve therapeutic goals and avoiding polytherapy with drugs known to increase systemic exposure and myopathy risk. Currently, the only effective treatment of statin-induced myopathy is the discontinuation of statin use in patients affected by muscle aches, pains and elevated CK levels.
他汀类药物被认为是安全的，耐受性良好的，也是治疗高胆固醇血症（动脉粥样硬化的主要危险因素之一）的最有效药物，因此经常被开处方。他汀类药物最严重的不良反应是肌毒性，表现为肌病、肌痛、肌炎或横纹肌溶解症。临床试验通常将他汀类药物毒性定义为肌痛或肌肉无力，肌酸激酶（CK）水平高于正常上限的 10 倍以上。横纹肌溶解症是他汀类药物最严重的不良反应，可能导致急性肾衰竭、弥漫性血管内凝血和死亡。他汀类药物引起的肌病的确切病理生理学机制尚不完全清楚。多种病理生理机制可能导致他汀类药物的肌毒性。这篇综述集中讨论了其中的一些机制。他汀类药物相关肌病的预防包括使用最低剂量的他汀类药物达到治疗目标，并避免与已知增加全身暴露和肌病风险的药物联合用药。目前，他汀类药物诱导的肌病的唯一有效治疗方法是停止使用他汀类药物，以治疗受肌肉疼痛、疼痛和 CK 水平升高影响的患者。
