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1例39岁男性患者因减肥自行口服奥利司他0.12 g、3次/d，用药4个月余出现四肢肌肉酸痛和双下肢无力，下肢肌力3级。实验室检查示丙氨酸转氨酶（ALT）65 U/L，天冬氨酸转氨酶（AST）125 U/L，肌红蛋白>3 997 μg/L，肌酸激酶（CK）2 889 U/L，CK-MB 71 U/L，血清肌酐（Scr）1 418 μmol/L；尿蛋白（+++），尿潜血（+）。考虑为奥利司他导致的横纹肌溶解症。停用奥利司他，并给予补液、碱化尿液、利尿等对症治疗。7 d后患者症状好转，下肢肌力恢复至4级。实验室检查示ALT 52 U/L，AST 68 U/L，肌红蛋白1 737 μg/L，CK 475 U/L，Scr 657 μmol/L，尿蛋白（+），尿潜血（n -）。1个月后，患者下肢肌力恢复至6级，实验室检查示ALT 35 U/L，AST 38 U/L，肌红蛋白624 μg/L，CK 192 U/L。患者未再出现肌痛及下肢无力症状。n “,”A 39-year-old male patient took orlistat 0.12 g thrice daily for weight loss. More than 4 months after medication, he developed muscle soreness of limbs and weakness of both lower limbs, with lower limb muscle strength at grade 3. Laboratory tests showed alanine aminotransferase (ALT) 65 U/L, aspartate aminotransferase (AST) 125 U/L, myoglobin>3 997 μg/L, creatine kinase (CK) 2 889 U/L, CK-MB (CK-MB) 71 U/L, serum creatinine (Scr) 1 418 μmol/L, urine protein (+++), and urine occult blood (+). Rhabdomyolysis caused by orlistat was considered. Orlistat was stopped and symptomatic treatments such as rehydration, alkaline urine, and diuretics were given. Seven days later, the patient′s symptoms were improved and the muscle strength of his lower limbs returned to grade 4. Laboratory tests showed ALT 52 U/L, AST 68 U/L, myoglobin 1 737 μg/L, CK 475 U/L, Scr 657 μmol/L, urine protein (+), and urine occult blood (-). One month later, the muscle strength of his lower limbs returned to grade 6. Laboratory tests showed ALT 35 U/L, AST 38 U/L, myoglobin 624 μg/L, and CK 192 U/L. The symptoms of myalgia and weakness of lower limbs did not recur.