Corpier C L, Jones P H, Suki W N, Lederer E D, Quinones M A, Schmidt S W, Young J B
Department of Medicine, Baylor College of Medicine, Methodist Hospital, Houston, TX 77030.
JAMA. 1988 Jul 8;260(2):239-41.
Hyperlipidemia, particularly hypercholesterolemia, occurs in cardiac transplant recipients both as a preexisting condition and as a consequence of immunosuppressive therapy. Lovastatin (Mevacor) has emerged as an agent that may effectively manage this condition. Few serious side effects of this drug have been observed. We describe two cardiac transplant recipients treated with lovastatin in conjunction with their other medications, including cyclosporine, who developed acute renal failure and rhabdomyolysis. Resolution of muscle damage followed discontinuation of cyclosporine and lovastatin therapy. We postulate that hepatic dysfunction secondary to cyclosporine predisposed these patients to lovastatin-induced muscle damage. Use of this drug in cardiac and other organ transplant recipients should be accompanied by close surveillance of creatine kinase, hepatic transaminases, and cyclosporine levels.
高脂血症，尤其是高胆固醇血症，在心脏移植受者中既作为一种既存病症出现，也作为免疫抑制治疗的结果而出现。洛伐他汀（美降脂）已成为一种可能有效控制这种病症的药物。该药物几乎未观察到严重的副作用。我们描述了两名心脏移植受者，他们在接受洛伐他汀治疗的同时还服用包括环孢素在内的其他药物，结果出现了急性肾衰竭和横纹肌溶解。停用环孢素和洛伐他汀治疗后，肌肉损伤得到缓解。我们推测，环孢素继发的肝功能障碍使这些患者易发生洛伐他汀诱导的肌肉损伤。在心脏和其他器官移植受者中使用该药物时，应密切监测肌酸激酶、肝转氨酶和环孢素水平。
