他汀类药物是3-羟基3-甲基戊二酰辅酶A还原酶抑制剂,是目前临床上广泛应用的降脂药物。他汀类药物所致肝损害(SILI)无特殊临床特征,与其他药物所致肝损害类似。SILI以肝细胞型多见,胆汁淤积型不常见,混合型少见。SILI的发生机制可能与药物本身的毒性、继发性效应及免疫机制等有关。高剂量、联合用药、肝病史等是SILI的危险因素。应用他汀类药物期间发生轻度肝损害者可减小药物剂量继续使用;发生中度肝损害者应在减量的同时使用保肝药物;发生严重肝损害者则需停药并采取相应的对症治疗措施。临床医师处方他汀类药物要注意严格掌握用药剂量,加强用药期间的实验室监测,尽量避免联合用药,并应嘱咐患者加强营养、注意休息。肝病患者慎用他汀类药物。大部分患者的SILI是可逆的。 Statins are 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitors, is currently widely used in clinical lipid-lowering drugs. There are no specific clinical features of statin-induced liver damage (SILI), similar to those caused by other drugs. SILI more common in hepatocellular type, cholestatic type is uncommon, mixed rare. The mechanism of SILI may be related to the toxicity of the drug itself, secondary effects and immune mechanisms. High dose, combination therapy, liver history and other SILI risk factors. Use of statins during mild liver damage can reduce the dose of the drug continue to use; occurred in patients with moderate liver damage should be reduced at the same time with the use of hepatoprotective drugs; in severe liver damage who need to stop and take the appropriate symptomatic treatment Measures. Clinician prescription statins should pay attention to strictly control dosage, strengthen laboratory monitoring during medication, try to avoid combination medication, and should be told patients to strengthen nutrition, pay attention to rest. Patients with liver disease with caution statins. SILI is reversible in most patients.