Maghsoodi Negar, Wierzbicki Anthony S
Department of Metabolic Medicine and Chemical Pathology, Guy's Hospital and St Thomas' Hospital, London, UK.
Curr Opin Cardiol. 2016 Jul;31(4):417-25. doi: 10.1097/HCO.0000000000000282.
Statins are recommended as first-line therapy for cardiovascular disease. Unfortunately, a proportion of patients cannot tolerate these drugs because of muscle-related side-effects. This review summarizes the definition of statin-related muscle disorders, aetiological factors, and recommended management strategies.
A number of consensus groups have defined and classified statin-related muscle disorders, whereas others have suggested diagnostic and management strategies. Mechanisms behind statin-related muscle toxicity have been identified. Therapeutic and clinical investigation pathways have been reviewed and algorithms defined. New drugs have become available to reduce low-density lipoprotein cholesterol levels that are not associated with causing muscle side-effects.
Statin-related muscle side-effects are common. Secondary causes of muscle disease unmasked by statin therapy should be identified. Most patients can be managed by adjustment of standard treatment protocols.
他汀类药物被推荐作为心血管疾病的一线治疗药物。不幸的是，一部分患者由于肌肉相关的副作用而无法耐受这些药物。本综述总结了他汀类药物相关肌肉疾病的定义、病因及推荐的管理策略。
多个共识小组对他汀类药物相关肌肉疾病进行了定义和分类，其他小组则提出了诊断和管理策略。已确定他汀类药物相关肌肉毒性的机制。对治疗和临床研究途径进行了综述并定义了算法。已有新型药物可降低低密度脂蛋白胆固醇水平，且不会引起肌肉副作用。
他汀类药物相关的肌肉副作用很常见。应识别出由他汀类药物治疗所掩盖的肌肉疾病的继发原因。大多数患者可通过调整标准治疗方案进行管理。
