Gencer Baris, Moradpour Darius, Rodondi Nicolas
Service de gastro-entérologie et d'hépatologie, Département de médecine, CHUV, 1011 Lausanne.
Rev Med Suisse. 2012 Mar 7;8(331):507-8, 510-2.
Statins are a cornerstone of cardiovascular prevention. Their utilization is mostly well tolerated and safe: the commonly reported hepatic adverse effect is an asymptomatic, reversible and dose-related increase in liver enzyme levels occurring in case of risks factors. Statins do not worsen liver function in most patients with chronic liver diseases, including nonalcoholic fatty liver disease and hepatitis C, and might be used cautionsly. However, decompensated cirrhosis and acute liver failure are contraindications for statins. Routine hepatic biochemical test monitoring is questioned and might be performed in following situations: chronic liver diseases, alcohol consumption, drug interactions. Other causes should be screened and treatment be temporarily withheld in case of an ALT elevation > 3 times the upper limit of the norm.
他汀类药物是心血管疾病预防的基石。它们的使用大多耐受性良好且安全：常见的肝脏不良反应是在存在风险因素时出现的无症状、可逆且与剂量相关的肝酶水平升高。他汀类药物在大多数慢性肝病患者中不会使肝功能恶化，包括非酒精性脂肪性肝病和丙型肝炎，并且可以谨慎使用。然而，失代偿期肝硬化和急性肝衰竭是他汀类药物的禁忌证。常规肝生化检查监测存在争议，可能在以下情况下进行：慢性肝病、饮酒、药物相互作用。如果谷丙转氨酶（ALT）升高超过正常上限的3倍，应筛查其他病因并暂时停用治疗。
