他汀类药物会损害肝肾功能吗 唐波 浙江大学医学院附属杭州市第一人民医院

他汀类药物会损害肝肾功能吗 唐波 浙江大学医学院附属杭州市第一人民医院
他汀类药物会损害肝肾功能。对于胆固醇增高或有卒中预防的患者，单纯的饮食控制是不行，需要服用药物控制，临床上非常重要的药物，也是预防脑卒中发生或复发的患者需要服用的药物，就是他汀类药物。往往在临床上看到有一部分患者很拒绝使用他汀类药物，可能跟这个药物会影响肝肾功能有关，其实他汀类的药物引起肝脏损害的这些患者是非常少数的，而它对于已经发生卒中的患者来说稳定斑块预防卒中的作用是非常明确，因此医生在平衡风险和收益的情况下，建议患者持续地服用他汀类的药物。那么怎么来考虑肝肾功损害的问题，首先需要动态的观测肝功能的转变，如果转氨酶升高在三倍以内，服用他汀类是不需要调整剂量，而超过三倍可以停药观察更换其他类的他汀类药物，对于一些老年人来说可以用调整剂量的方法避免肾功能的损害。

Can statins damage liver and kidney function
Statins can damage liver and kidney function. For patients with elevated cholesterol or stroke prevention, Simple diet control is not good, Drug control is needed, Clinically important drugs, It is also a drug to prevent the occurrence or recurrence of stroke, It's statins. It is often seen that some patients refuse to use statins, It may be related to the effect of this drug on liver and kidney function, In fact, these patients with liver damage caused by statins are very few, And it's very clear for patients who have already had stroke that stabilizing plaque can prevent stroke, So doctors balance risks and benefits, Patients are advised to continue taking statins. So how to consider the damage of liver and kidney function, First, we need to observe the change of liver function dynamically, If transaminase rises within three times, Statins do not need to be adjusted, If it's more than three times, you can stop taking other statins, For some old people, we can adjust the dosage to avoid the damage of renal function.