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目的探讨他汀类药物相关肌病的临床表现和肌肉病理学特点。方法对1例他汀相关肌病患者进行临床、电生理、病理学和随访研究。结果患者为65岁女性,体重指数为20.9,因胆固醇升高服用辛伐他汀,1月后出现肌痛、肌无力症状,进行性加重。查血磷酸肌酸激酶(CK)为1522U/L;肌电图表为运动单位动作电位时限缩短及病理干扰相;左股四头肌活检示肌纤维灶状坏死,油红染色可见阳性纤维;透射电镜检查发现肌纤维内出现成串脂滴。立即停药并给予对症治疗。随访半年后,患者症状完全消失,CK恢复正常。结论该患者临床表现和电生理提示肌肉损害;病理学表现为肌纤维脂质代谢障碍的特点,符合他汀类相关肌病。老年女性患者使用他汀类药物时应注意监测其不良反应。
Objective To investigate the clinical manifestations and muscle pathology of statin-related myopathies. Methods One case of statin-related myopathy was studied by clinical, electrophysiological, pathological and follow-up. Results The patient was 65 years old and had a body mass index of 20.9. Simvastatin was taken due to elevated cholesterol, and myalgia and myasthenia developed after January. Check the blood creatine kinase (CK) was 1522U / L; electromyogram as the motor unit action potential shortening and pathological interference phase; left quadriceps muscle biopsy showed focal necrosis of muscle fibers, red staining visible positive fibers; transmission electron microscopy Found in the muscle fibers found in the string of lipid droplets. Immediate withdrawal and symptomatic treatment. After six months of follow-up, the patient’s symptoms completely disappeared, CK returned to normal. Conclusion The clinical manifestations and electrophysiological findings suggest muscle damage. The pathological features of dyslipidemia in myofibers are consistent with statin-related myopathies. Elderly women should pay attention to the monitoring of adverse reactions when using statins.