与他汀类药物和癫痫发作相关的横纹肌溶解症3 例报告.pdfVIP

2011;31(10) 南方医科大学学报（J South Med Univ ） ·1795 · ·病例报告· 与他汀类药物和癫痫发作相关的横纹肌溶解症3 例报告 管玉青，石彦杰，王 群 南方医科大学南方医院神经内科，广东 广州 510515 摘要：目的分析与癫痫发作和他汀类药物相关的横纹肌溶解症的临床特点。方法报道3 例诊断明确的横纹肌溶解症患 者的临床资料，对相关文献进行复习。结果3 例患者均于癫痫发作和/或服用他汀类药物后出现横纹肌溶解，3 例均有茶 色尿，其中2 例有腰痛症状，CK 均显著升高达正常上限50倍以上。停药及相关治疗后，CK仍继续上升2~3 d后达到峰值， 1~2 周后降至正常范围。3 例患者均未出现肾功能损害。结论 癫痫发作和他汀类药物应用是导致横纹肌溶解症的常见 原因，有癫痫发作的患者应用他汀类药物时应特别注意监测相应症状体征和心肌酶谱，及时处理。 关键词：横纹肌溶解症；他汀类药物；癫痫发作 中图分类号：R685.5 文献标志码：A 文章编号：1673-4254（2011）10-1795-02 Rhabdomyolysis related to statin and seizures: report of 3 cases GUAN Yu-qing, SHI Yan-jie, WANG Qun Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Abstract: Objective To investigate the clinical features and prognosis of rhabdomyolysis related to seizure attacks and use of statin. Methods The medical records of 3 patients with established diagnosis of rhabdomyolysis were analyzed and the related literatures were reviewed. Results All the 3 patients had seizure attacks and/or used statin before the onset of rhabdomyolysis. Two of the patients complained of back pain, and all the 3 patients had dark-colored urine. Serum levels of creatine kinase (CK) were markedly increased by over 50 times above the normal upper limit. CK level kept increasing even after proper interventions, till reaching the peak level about 3 days later. The patients improved rapidly with full recovery thereafter, and CK became normal in 2 weeks. None of the patients had renal failure. Conclusion Seizure attacks and use of statin are common risk factors for non-traumatic rhabdomyolysis. Caution needs to be taken when prescribing statin to patients with recent seizur