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齐多夫定(AZT)为核苷类似物,是治疗艾滋病病毒感染的一线药物。自1987年开始陆续有AZT相关肌病的报道,其发生率为2%～18%。临床表现为肌痛、肌无力和肌酶升高。AZT引起肌病的机制可能和骨骼肌线粒体受损有关。其防治方法包括:(1)治疗时开始用小剂量,之后逐渐增加至规定剂量。(2)治疗过程中监测肌酶水平。(3)一旦确定肌病和齐多夫定有关应立即停药,并可应用糖皮质激素、辅酶Q、肉碱等药物治疗。
Zidovudine (AZT) is a nucleoside analog that is the first-line drug for the treatment of HIV infection. Since 1987, there have been reports of AZT-related myopathy, the incidence rate of 2% to 18%. Clinical manifestations of muscle pain, muscle weakness and elevated muscle enzymes. The mechanism by which AZT causes myopathy may be related to the impairment of mitochondria in skeletal muscle. The prevention and treatment methods include: (1) treatment began with a small dose, and then gradually increased to the prescribed dose. (2) monitoring of muscle enzyme levels during treatment. (3) once identified myopathy and zidovudine should be immediately discontinued, and can be applied glucocorticoid, coenzyme Q, carnitine and other drugs.