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題 名 | Statin類藥物相關的肌肉症狀=Statin-associated Muscle Symptoms |
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作 者 | 楊璦瑜; 郭震羣; | 書刊名 | 藥學雜誌 |
卷 期 | 34:2=135 2018.06[民107.06] |
頁 次 | 頁104-109 |
分類號 | 418.227 |
關鍵詞 | 降血脂藥物; 肌肉症狀; Statin; Muscle symptom; Low-density lipoprotein; |
語 文 | 中文(Chinese) |
中文摘要 | Statin,HMG-CoA 還原酶抑製劑,是目前廣泛使用的降血脂藥物,並為心血管疾 病的預防及治療藥物。Statin 類藥物相關的肌肉症狀 (SAMS),不一定伴隨肌酸激酶升 高;症狀廣泛,從肌痛到顯著的肌酸酐酶升高或出現臨床橫紋肌溶解症。SAMS 是影 響服藥遵從性與停藥的主要原因之一,根據過去觀察性研究顯示盛行率約為7-29%。 當病人主訴有肌肉症狀時,須評估相關風險因子,排除其他影響因素 (如甲狀腺機能 低下、其他的肌肉病變、運動量增加等),並確認使用 statin 藥物治療的必要性。在 statin 藥物與肌肉症狀的因果關係無法確診時,歐洲動脈硬化學會建議藉由中斷治療與 重複再挑戰,觀察症狀變化來評估相關性。理想的治療為使用可耐受的最大 statin 劑 量或非每日劑量的治療策略,併用非 statin 類的降血脂藥物以達到低密度脂蛋白的治 療目標。 |
英文摘要 | Statins, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, are the most widely used lipid-lowering drugs. Statins are the primary class of medication used for prevention and treatment of cardiovascular disease. Statin-associated muscle symptoms (SAMS) can occur without creatine kinase (CK) elevation. The muscle syndromes cover a broader range from myalgia to marked CK elevations and/or clinical rhabdomyolysis. SAMS are one of the principal reasons for statin non-adherence and/or discontinuation, with a prevalence of 7-29% in observational studies. If a patient complains of muscle symptoms, the clinician needs to evaluate risk factors which can predispose to SAMS, exclude secondary causes (especially hypothyroidism and other common myopathies, or increased physical activity), and review the necessity for statin use. Its diagnosis is challenging of potential link between statins and muscle symptoms. The European Atherosclerosis Society (EAS) Consensus Panel recommends to observed the change of symptoms and their relationship with statin initiation, statin discontinuation, and repetitive re-challenge. Optimal therapy should combine a maximally tolerated statin dose, or non-daily dosing strategies, together with non-statin-based lipid-lowering therapies in order to achieve LDL-C targets. |
本系統中英文摘要資訊取自各篇刊載內容。