与人体免疫缺陷病毒和齐多夫定相关的肌病

摘要

肌病可能是人类免疫缺陷病毒1型(HIV)感染或其治疗的并发症，齐多夫定(ZDV)。我们回顾了我们对hiv感染患者进行神经肌肉评估的经验，并比较了ZDV治疗(+ZDV)和未治疗(-ZDV)患者肌病的特征。50例患者有肌病，25例由病理标准诊断，25例由临床和其他实验室支持。20例肌病患者体重减轻，足以诊断为HIV消耗综合征。31例为+ZDV, 19例为-ZDV。两组患者均表现为近端无力，但肌痛在+ZDV患者中更为常见。两组血清CK升高程度相似(中位数:+ZDV, 485;-ZDV, 471)。肌肉活检显示两组肌纤维变性、炎性浸润、包涵体和线粒体异常。我们随访了15例患者对ZDV停药的反应。 Four had increased strength, three noted less myalgia, and eight had no clinical improvement. Twelve of 13 patients improved with prednisone. Although it is difficult to distinguish the myopathies of HIV and ZDV by clinical or pathologic criteria, in the majority of our patients, myopathy is due to HIV rather than ZDV.