治疗他类药物的儿童和青少年的肌肉病:一种实际的方法
1University of Rochester Medical Center, 1475 East Avenue, Rochester, NY, 14610, USA. rekavey@gmail.com.
Current atherosclerosis reports
|September 24, 2024
概括
在儿童中,他类药物诱导的肌肉病症很少见. 无症状年轻人不需要进行常规肌酸激酶监测,但应评估肌肉疼痛的患者,并且需要立即提供医疗照顾.
科学领域:
- 儿科药理学 儿科药理学
- 临床毒理学 临床毒理学
- 心血管治疗的治疗方法
背景情况:
- 类药物越来越多地用于儿科失脂症.
- 斯坦丁相关肌肉病是已知的成年人的不良影响.
- 关于小儿群体中他类药物肌肉病的数据有限.
研究的目的:
- 审查当前关于儿童和青少年的他类药物相关肌肉病的文献.
- 为指导儿童使用他类药物的实际管理策略的制定提供指导.
主要方法:
- 对儿科病人的他类药物治疗研究的系统性文献综述.
- 分析报告的肌肉病变病例,包括肌酸激酶 (CK) 水平和症状.
- 随机对照试验 (RCT) 的评估,比较他类药物使用者和对照者.
主要成果:
- 大多数儿科的他类药物使用报告显示没有肌肉病理.
- 无症状的CK升高和没有CK升高的肌肉疼痛在RCT中的他类药物使用者和对照者中发生了类似的情况.
- 在接受他类药物治疗的儿童中报告了罕见的狂肠分裂病例,这是以前未经记录的问题.
结论:
- 在童年时,他类药物诱导的肌肉病变并不常见.
- 在无症状儿科患者中不建议进行常规CK监测.
- 应该只对有症状的患者进行CK监测;对于迅速的医疗干预,对骨髓溶解症状 (暗色尿液,肌肉疼痛) 的教育至关重要.
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