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Safety of statins.

机译：他汀类药物的安全性。

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PURPOSE OF REVIEW: To examine the evidence for the adverse effects that have been reported during the use of statins. RECENT FINDINGS: We now have over twenty years of prescription use and many large well controlled trials with statin therapy for hypercholesterolemia. There is only one significant and well documented adverse effect with this group of drugs, rhabdomyolysis. Significant muscle damage is very rare when statin therapy is used in patients carefully screened for concomitant use of other drugs which may interfere with statin catabolism and excretion. Patients with severely impaired liver function are also at risk due to the importance of hepatic excretion of all statins. Chronic myalgias or other pain syndromes have not been confirmed by blinded placebo controlled trials. A significant and reproducible rise in liver enzymes (alanine and aspartate aminotransferases) is observed in 1 to 3% of patients but actual liver damage may not occur at all. Benign and transient proteinuria occurs without evidence of altered renal function. Creatinine clearance is usually increased by statins. Peripheral neuropathy may be a rare adverse effect and this needs further study. SUMMARY: Statins are very effective at reducing the incidence of myocardial infarction, stroke and other manifestations of vascular disease. The adverse event rates are very uncommon and the benefit risk ratio is extremely high.
机译：审查目的：检查使用他汀类药物期间已报告的不良反应的证据。最新发现：我们已有超过20年的处方使用时间，以及许多针对他汀类药物治疗高胆固醇血症的大型对照试验。该组药物横纹肌溶解症只有一种明显且有据可查的不良反应。当对他汀类药物疗法进行仔细筛查的患者同时使用其他可能会干扰他汀类药物分解代谢和排泄的药物时，严重的肌肉损伤非常罕见。由于所有他汀类药物的肝排泄的重要性，肝功能严重受损的患者也有危险。盲法安慰剂对照试验尚未证实慢性肌痛或其他疼痛综合征。在1-3％的患者中观察到肝酶（丙氨酸和天冬氨酸转氨酶）显着且可重现的升高，但实际上根本不会发生肝损伤。发生良性和短暂性蛋白尿，无肾功能改变的证据。他汀类药物通常会增加肌酐清除率。周围神经病变可能是罕见的不良反应，这需要进一步研究。摘要：他汀类药物在减少心肌梗塞，中风和其他血管疾病表现方面非常有效。不良事件发生率非常罕见，受益风险比极高。

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