使用statin者併發因運動導致的橫紋肌溶解症－個案報告

60歲中年女性，規律使用藥物控制高血壓和高膽固醇血症，出現發燒、下肢肌肉疼痛、後腰背部不適，基層醫師診斷為「感冒」，但在使用症狀緩和藥物後，相關徵狀未見改善且發現茶色尿，故轉到醫學中心求診，經實驗室檢驗發現血清肌酸激酶(creatine kinase, CK)濃度和肝功能指數異常高及尿肌蛋白陽性，診斷「橫紋肌溶解症」，病患住院接受支持性治療，同時立即停用有潛在風險肌病變的常規降血脂藥statin；病史發現症狀出現前二天病人曾體能耗竭的騎腳踏車，推論橫紋肌溶解症是因激烈運動所致，6天後確認相關症狀、CK和肝功能指數皆明顯改善後離院；三個月後家庭醫學門診回診，因LDL-C高，再次以statin藥來控制降血脂，追蹤3年，病患狀況良好，不曾有statin相關肌病變徵狀。

關鍵字

降血脂藥；體能耗竭；橫紋肌溶解症

並列摘要

A middle-aged woman who had hypertension and hypercholesterolemia with regular medial control, presented with fever, lower extremity muscle and flank aching. She visited a local medical clinic that failed to provide symptom relief. Noticing tea color urine, she sought help from a medical center. Laboratory investigation revealed elevated serum level of creatine kinase (CK) and liver functions and positive for urine myoglobin. She was admitted for supportive care under the impression of rhabdomyolysis. Her usual medication for lipid lowering, statin was immediately withheld for its potential of causing myopathy. History indicated that, 2 days before the symptoms, she had biked vigorously and that might be the cause of the acute illness. She was discharged at the sixth day of hospitalization with symptoms and serum levels of CK and liver function significantly improved. Three months after she was followed up at a family medicine department. Statin was reused to lower her high low-density lipoprotein. The patient has been well and no report of any signs of myopathy in the following 3 years.

並列關鍵字

lipid lowering agents ； physical exertion ； rhabdomyolysis

國際替代計量

使用statin者併發因運動導致的橫紋肌溶解症－個案報告

全文下載

主題瀏覽