Batchelor T T, Taylor L P, Thaler H T, Posner J B, DeAngelis L M
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Neurology. 1997 May;48(5):1234-8. doi: 10.1212/wnl.48.5.1234.
We prospectively evaluated 15 adult cancer patients being treated with adrenocorticosteroids (steroids) to determine the frequency and time course of "steroid myopathy." Nine (60%) developed clinically detectable proximal muscle weakness that, in six, was severe enough to interfere with activities of daily living. Proximal muscle weakness developed within 15 days in eight of nine patients and was significantly related to the cumulative dose of steroid. Eight of nine patients with proximal muscle weakness, and two of six without such weakness, experienced a significant decline in respiratory function, leading to symptomatic dyspnea in four patients of the former group. In three patients who could be followed for more than 3 months off steroids, there was either improvement or resolution of the weakness and, when present, of the respiratory impairment. Steroid myopathy is a common complication among cancer patients receiving steroids. It can often affect respiratory function even when proximal limb muscles remain strong. Clinical recognition is important since steroid myopathy can lead to increased morbidity and may be reversible with reduction or discontinuation of steroids.
我们前瞻性评估了15例接受肾上腺皮质类固醇(类固醇)治疗的成年癌症患者,以确定“类固醇肌病”的发生率和病程。9例(60%)出现临床上可检测到的近端肌无力,其中6例严重到足以干扰日常生活活动。9例患者中有8例在15天内出现近端肌无力,且与类固醇的累积剂量显著相关。9例近端肌无力患者中有8例,6例无此类肌无力的患者中有2例出现呼吸功能显著下降,导致前一组中的4例患者出现症状性呼吸困难。在3例停用类固醇后可随访3个月以上的患者中,肌无力或有改善或消失,呼吸功能障碍若存在也同样如此。类固醇肌病是接受类固醇治疗的癌症患者中的常见并发症。即使近端肢体肌肉保持强壮,它也常可影响呼吸功能。临床识别很重要,因为类固醇肌病可导致发病率增加,减少或停用类固醇后可能可逆。