作者或演讲者：TseliosK，etal.
译者：邓晓莉
发布：郭越校对：王振青
摘要
目的：研究狼疮患者中应用抗疟药与肌酶升高的关系。
方法：共纳入例至少在连续两次门诊随访中都有肌酶升高的狼疮患者，其中排除54例服用他汀药的患者和14例合并活动性肌炎的患者。对照组为例无肌酶升高的狼疮患者。应用描述性统计分析及Cox回归方法分析资料。
结果：两组之间基线资料匹配。病例组抗疟药的应用更多，应用时间更长。应用抗疟药的患者中肌酶升高的比例为/（16.3%），氯喹和羟氯喹导致肌酶升高的风险分别是3.3倍和3.1倍。非洲裔人种肌酶升高风险更大，而女性为保护因素。例患者共随访7.3?±?5.6年，49.8%的患者肌酶持续升高，14.8%间断升高，而35.4%肌酶逐渐正常。5例患者出现有临床症状的近端肌无力。
结论：长期应用抗疟药可能是狼疮患者肌酶升高的危险因素。在2/3的患者中肌酶持续升高，但多数仅仅是一种生化检查异常，其中2.5%发展为有临床症状的肌病。
END附原文：
OBJECTIVE:Toinvestigatetherelationshipbetweenantimalarials(AM)andelevatedmuscleenzymesinsystemiclupuserythematosus(SLE).PATIENTSMETHODS:lupuspatientswithabnormalcreatinephosphokinase(CPK)foratleasttwoconsecutiveclinicvisitswereenrolled;54patientsonstatins/fibrates(n?=?43)and/oractivemyositis(n?=?14)wereexcluded.ThecontrolgroupconsistedoflupuspatientswithnoCPKelevationduringfollow-up.DescriptivestatisticsandCoxregressionanalyseswereperformed,p??0.05wasconsideredsignificant.
RESULTS:CasesandcontrolsdidnotdifferregardingageatSLEdiagnosis,genderratio,ordiseaseduration.AMusewasmorefrequentincases,whichhadmoreprolongedAMuse.TotalfrequencyofelevatedCPKinAMuserswas/(16.3%).Chloroquinewasassociatedwitha3.3-fold,andhydroxychloroquinewitha3.1-fold,increasedriskforCPKelevation.BlackracewasassociatedwithhigherCPK(HR?=?2.),whereasfemalegenderwasprotective(HR?=?0.).patientswerefollowedfor7.3?±?5.6years;49.8%hadpersistentand14.8%intermittentCPKelevation,whilein35.4%CPKwasnormalized.Clinicalproximalmuscleweaknessdevelopedin5/patients.
CONCLUSIONS:ChronicAMuseisapotentialriskfactorformuscleenzymeelevationinSLEpatients.CPKabnormalitiespersistinalmosttwothirdsofthepatients,butthisremainsmainlyabiochemicalfinding,evolvingtoclinicalmyopathyinabout2.5%.
引自：TseliosK,GladmanDD,SuJ,etal.Antimalarialsasariskfactorforelevatedmuscleenzymesinsystemiclupuserythematosus.Lupus,,12(3):-67
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