Statins in COPD A Systematic Review
Statins in COPD A Systematic Review
复制标题
DOI：
10.1378/chest.09-0194
复制
发表时间：
2009-09-01
期刊：
影响因子：
9.6
通讯作者：
Swiston, John
中科院分区：
文献类型：
--
作者：
Janda, Surinder;Park, Kirly;Swiston, John
背景资料：3-羟基3-甲基戊二酰辅酶A还原酶抑制剂（即他汀类药物）广泛用于治疗高胆固醇血症和心血管疾病患者。新出现的证据表明，他汀类药物对COPD患者的发病率和死亡率有有益的影响。本研究的目的是进行一项系统的文献综述，评价他汀类药物治疗对COPD患者预后的影响。方法：检索Medline、Excerpta Medica Database、PapersFirst、科克伦协作和科克伦注册的对照试验。随机对照试验（RCTs），观察性队列研究，病例对照研究，和基于人群的分析被认为including.Results：9项研究被确定为审查（4个回顾性队列，一个嵌套的病例对照研究的回顾性队列，一个回顾性队列和病例系列，两个基于人群的分析，和一个随机对照试验）。所有研究均显示，他汀类药物治疗对COPD患者的各种结局均有获益，包括COPD急性加重次数（n = 3）、COPD相关插管次数和时间（n = 1）、肺功能（例如，FEV 1和FVC）[n = 1]、运动能力（n = 1）、COPD死亡率（n = 2）和全因死亡率（n = 3）。没有研究描述了他汀类药物治疗对COPD patients.Conclusions结果的负面或中性影响：目前的文献共同表明，他汀类药物可能在COPD的治疗中发挥有益的作用。然而，大多数已发表的研究具有回顾性研究和基于人群的分析的固有方法学局限性。需要专门设计前瞻性干预试验来评估他汀类药物对COPD临床相关结局的影响。（CHEST 2009; 136：734-743）
Background: The 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitors (ie, statins) are widely used for the treatment of patients with hypercholesterolemia and cardiovascular disease. Emerging evidence suggests a beneficial effect of statins on the morbidity and mortality of patients with COPD. The objective of this study was to perform a systematic review of the literature evaluating the effect of statin therapy on outcomes in patients with COPD.Methods: Medline, Excerpta Medica Database, PapersFirst, and the Cochrane collaboration and Cochrane Register of controlled trials were searched. Randomized controlled trials (RCTs), observational cohort studies, case-control studies, and population-based analyses were considered for inclusion.Results: Nine studies were identified for review (four retrospective cohorts, one nested case-control study of a retrospective cohort, one retrospective cohort and case series, two population-based analyses, and one RCT). All studies showed a benefit from statin therapy for various outcomes in COPD patients, including the number of COPD exacerbations (n = 3), the number of and time to COPD-related intubations (n = 1), pulmonary function (eg, FEV1 and FVC) [n = 1], exercise capacity (n = 1), mortality from COPD (n = 2), and all-cause mortality (n = 3). No studies describing a negative or neutral effect from statin therapy on outcomes in COPD patients were identified.Conclusions: The current literature collectively suggests that statins may have a beneficial role in the treatment of COPD. However, the majority of published studies have inherent methodological limitations of retrospective studies and population-based analyses. There is a need for prospective interventional trials designed specifically to assess the impact of statins on clinically relevant outcomes in COPD. (CHEST 2009; 136:734-743)