摘要
他汀类药物为3-羟基-3-甲基戊二酰辅酶A(HMG-CoA)还原酶抑制剂,具有减少内源性胆固醇合成的作用,主要用于高胆固醇血症和混合型高胆固醇血症的治疗以及冠心病和脑卒中的防治。他汀类药物的常见不良反应有腹泻、恶心、头痛及皮疹等。1996年Bruckert等首先报告了他汀类药物可致勃起功能障碍(ED)。1985年1月1日至2006年12月31日法国药物警戒系统收集到4471例服用他汀类药物所致不良反应报告,其中有51例(1.14%)为ED,包括辛伐他汀19例,阿托伐他汀18例,帕伐他汀8例,瑞舒伐他汀4例,氟伐他汀2例。使用他汀类药物后发生ED的平均时间为62d(中位数29d,范围1～100d),其中25%的患者在9d内、75%的患者在75d内发生。约有57%的患者在停药后性功能恢复正常。他汀类药物引致ED的机制可能与其减少胆固醇生成而影响甾体激素(包括睾酮)的合成以及患者个体差异和心理状态有关。防治措施:他汀类药物应避免与其他可能引致ED的药物联用,如抗精神病药、三环类抗抑郁药、贝特类降血脂药和β-受体阻滞剂;一旦发生ED,应停药或换用其他降脂药。
Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A （HMG-CoA） reductase.They have actions on reduction of endogenous cholesterol synthesis and are mainly used for the treatment of hypercholesterolemia,mixed hypercholesterolemia,and for the prevention of coronary heart disease and stroke. The most common adverse reactions of statins are diarrhea,nausea,headache and rash. Erectile dysfunction （ED） in association with statins was first reported by Bruckert in 1996. A total of 4 471 case reports of statin-induced adverse reactions were collected by French Pharmacovigilance System from 1 January 1985 to 31 December 2006.Of them,51 reports（1.14%） were statin-induced ED,including simvastatin （19 cases）,atorvastatin （18 cases）,pravastatin （8 cases）,rosuvastatin （4 cases）,and fluvastatin （2 cases）. The mean time to ED onset after starting statins was 62 days （median 29 days,range 1-100 days）：25% of patients within 9 days and 75% of patients within 75 days after starting statins. Approximately 57% of cases recovered after withdrawal of statins. The mechanism of statin-induced ED may be attributed to the influence of cholesterol reduction on steroid hormone （including testosterone） synthesis,as well as individual differences and psychological state. The preventive and therapeutic measures are as follows：concomitant use of drugs that may caused ED should be avoided,such as antipsychotics,tricyclic antidepressants,fibrate lipid-lowering drugs,and β-blockers; if ED induced by statins is confirmed,the statins should be discontinued or changed to other lipid-lowering drugs.
出处
《药物不良反应杂志》
2010年第2期105-108,共4页
Adverse Drug Reactions Journal
