Rudski L, Rabinovitch M A, Danoff D
McGill University Hospital Centre, Division of Cardiology, Montreal, Quebec, Canada.
Medicine (Baltimore). 1998 Nov;77(6):378-83. doi: 10.1097/00005792-199811000-00002.
Four patients with systemic autoimmune disorders, 3 of a serious nature, presented to 1 cardiologist over a 20-month span. In 3 of these cases, an HMG-CoA reductase inhibitor was presumably etiologic, while in the fourth case, the HMG-CoA reductase inhibitor might have unmasked the disorder. It would be useful to determine the true frequency of this complication, particularly in older patients not included in most of the statin trials to date. It is well established that autoimmune phenomena and particularly the development of autoantibodies increase with age. The data presented in this report that the group of HMG-CoA reductase inhibitors could be a heretofore poorly recognized etiologic agent. This issue might be addressed by a case-control study looking at the prevalence of statin use in elderly patients with systemic autoimmune disorders and in controls. Until then, the authors advise caution in the use of this class of medications in patient subgroups for whom no clear-cut clinical benefit has yet been proven.
在20个月的时间里，有4例患有全身性自身免疫性疾病的患者（其中3例病情严重）前来就诊于1位心脏病专家。在其中3例病例中，HMG - CoA还原酶抑制剂据推测是病因，而在第4例中，HMG - CoA还原酶抑制剂可能是引发了该疾病。确定这种并发症的真实发生率将很有帮助，尤其是在大多数他汀类试验迄今未纳入的老年患者中。众所周知，自身免疫现象尤其是自身抗体的产生会随着年龄增长而增加。本报告中所呈现的数据表明，HMG - CoA还原酶抑制剂组可能是一种迄今未被充分认识的病因。这个问题可以通过一项病例对照研究来解决，该研究观察全身性自身免疫性疾病老年患者和对照组中他汀类药物的使用 prevalence。在此之前，作者建议在尚未证明有明确临床益处的患者亚组中谨慎使用这类药物。
