（来源：中国医药报） 转自：中国医药报 □ 李橙妍 横纹肌溶解综合征是一种由多种原因引起的肌肉疾病，虽不常见但却非常严重，使用某些药物是其重要 的诱发因素。了解药物诱发横纹肌溶解的机制，科学规范用药，有助于避免发生。 疾病症状 用药提醒 可引起横纹肌溶解的药物有他汀类药物、贝特类药物等。 他汀类药物可以降低血胆固醇、调节血脂，可用于治疗高脂血症，同时还可以用于预防动脉粥样硬化形 成，代表药物有阿托伐他汀、普伐他汀、瑞舒伐他汀等。该类药物通过抑制甲羟戊酸途径，减少辅酶 Q10和胆固醇合成，导致肌细胞膜稳定性下降和线粒体功能障碍，从而诱发横纹肌溶解；且横纹肌溶解 的风险随着药物使用剂量的增加而升高。另外，该类药物与环孢素、吉非罗齐、红霉素、克拉霉素、伊 曲康唑、酮康唑、泊沙康唑、伏立康唑、秋水仙碱等药物或葡萄柚汁联合服用，也会使横纹肌溶解的风 险升高。 贝特类药物也具有调节血脂的作用，可用于治疗高甘油三酯血症、高胆固醇血症等疾病，代表药物有非 诺贝特、苯扎贝特等。该类药物可能干扰肌肉细胞能量代谢，导致肌细胞膜稳定性下降，进而引起横纹 肌溶解。 除上述药物外，抗精神病药物（如氟哌啶醇、奥氮平、利培酮、喹硫平、氯氮平 ...

Group 1 - Cholesterol is an essential substance for the human body, playing a critical role in synthesizing hormones and vitamin D, and forming cell membranes [3][4] - Cholesterol levels can be influenced by both internal factors (genetics, diseases) and external factors (lifestyle habits such as diet and exercise) [4] - There are two types of cholesterol: high-density lipoprotein (HDL-C) known as "good cholesterol" and low-density lipoprotein (LDL-C) known as "bad cholesterol" [5][6] Group 2 - High levels of LDL-C can lead to serious health issues such as coronary heart disease and stroke, while HDL-C helps to remove excess cholesterol from the bloodstream [6][7] - It is important to assess cholesterol health through a comprehensive analysis of various blood lipid indicators, not just total cholesterol [8][10] - Individual cholesterol levels can vary based on personal health history, age, and lifestyle, making it essential to consider these factors when evaluating cholesterol [7][8] Group 3 - Dietary recommendations for lowering cholesterol include increasing intake of whole grains and high-quality fats while avoiding saturated and trans fats [10][12][14] - Regular physical activity is advised, with recommendations for at least 150 minutes of moderate-intensity aerobic exercise per week [22] - If lifestyle changes are insufficient, medication may be necessary, with common options including statins and cholesterol absorption inhibitors [24][25]