目的：调查他汀类药物引起横纹肌溶解症的临床特征、发生原因及治疗措施。方法：以“他汀”、“横纹肌溶解”为检索词，检索PubMed、CNKI、VIP数据库，对患者的一般情况、用药情况、横纹肌溶解症的临床表现、用药关联性、治疗与转归等进行分析。结果：共纳入54篇文献，合计59例患者。他汀类药物所致横纹肌溶解症多发生于70岁以上患者。乏力、肌痛是他汀类药物致肌病的主要临床症状。辛伐他汀引起横纹肌溶解发病率最高，共35例（59.32%）。用药至发病最短时间为12 h，最长超过10年，多数累计用药时间大于1年。经过对症治疗后，45例痊愈，11例好转，3例死亡。结论：密切观察应用他汀类药物患者的临床表现及生化指标检测结果，他汀类药物对高龄、合并用其他调脂药的患者可能会增加肌病发生的风险，易出现肾功能损害，一旦出现横纹肌溶解，应立即停药，给予血液净化、碱化尿液、保护肝肾功能等治疗。%Objective:To investigate the clinical features and causes of rhabdomyolysis induced by statins,and provide the preventive measures. Methods: PubMed,CNKI, VIP data base were retrieved by using the key words of statins and rhabdomyolysis in Chinese and English, respectively. The baseline characteristics of the patients, the situation of drug use, the clinical manifestations, the drug-related analysis, the outcome of treatment and prognosis were analyzed. Results:There were 54 cases reports referred to 59 patients suffering rhabdomyolysis induced by statins. Rhabdomyolysis was mostly occurred in the patients above 70 years old. Weakness and myalgia were the main clinical symptoms. The incidence of rhabdomyolysis induced by simvastatin was the highest, which accounted for 59.32% (35 cases). The onset time of rhabdomyolysis after the drug administration was as follows:the shortest was 12 hours, the longest was 10 years, and the cumulative time of medication was 1 year. A total of 45 cases recovered after discontinuing usage of statins and symptomatic treatment, 11 cases improved and 3 cases died. Conclusion:Clinical manifestations should be paid more attention to and it is necessary to monitor biochemical indicators. Elderly and combination therapy with other lipid-regulating drugs may increase the risks of rhabdomyolysis. Once rhabdomyolysis occurred, statins should be stopped immediately, blood puriifcation, urinary alkalinization, as well as kidney protective treatment should be given subsequently.
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