患者女，76岁，因“全身肌肉疼痛，伴乏力1周”入院。因冠心病长期服用降脂药“辛伐他汀(舒将之)20 mg/晚”，约2月前改用“辛伐他汀(京新)40 mg/晚”。入院后完善相关检查，肌酸激酶明显升高，肾功能轻度受损。诊断上考虑为：辛伐他汀导致的横纹肌溶解症。该病例特点：1)长期服用辛伐他汀未见不良反应，更换厂家及增加剂量2月后出现不良反应；2)肌酸激酶水平的显著升高；3)如此高的肌酶水平却并没有出现严重的肾功能损害，预后良好。%A 76-year-old female was hospitalized because of “generalized muscle pain, with weakness for 1 week”. The patient had coronary heart disease and take simvastatin 20 mg per night. In recent 2 months, she changed the drug manufacturer and take 40 mg per night. The patient’s creatine kinase increased significantly with a slight renal impairment. hTe diagnosis is: rhabdomyolysis caused by simvastatin. hTe case has follow features: 1) before replaced the manufacturer and increased the dose, the adverse effects never appear; 2) a signiifcantly increased creatine kinase level; 3) such a high level of creatine kinase did not cause serious renal failure.
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