An assessment of the effect of statin use on the incidence of acute respiratory infections in England during winters 1998-1999 to 2005-2006
An assessment of the effect of statin use on the incidence of acute respiratory infections in England during winters 1998-1999 to 2005-2006
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DOI：
10.1017/s0950268810000105
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发表时间：
2010-09-01
影响因子：
4.2
通讯作者：
Nguyen-Van-Tam, J. S.
中科院分区：
文献类型：
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作者：
Fleming, D. M.;Verlander, N. Q.;Nguyen-Van-Tam, J. S.
他汀类药物可降低心血管死亡率和与肺炎相关的风险，这表明他汀类药物可能有益于流感大流行。我们调查了目前他汀类药物在初级保健中对急性呼吸道感染的影响。来自年龄45岁的匿名电子病历的数据被检查了他汀类药物的使用、慢性发病率、呼吸道诊断、疫苗接种程序和免疫抑制。Logistic回归模型用于计算使用他汀类药物与不使用他汀类药物的呼吸道感染结局的优势比(OR)。总计329881人年观察，包括18%的他汀类药物使用者和46%的流感疫苗接种者。使用他汀类药物与未使用他汀类药物的患者调整后的OR值分别为：流感样疾病1.05(95%CI 0.92~1.20)；急性支气管炎1.08(95%CI 1.01~1.15)；肺炎0.91(95%CI 0.73~1.13)；所有急性呼吸道感染1.03(95%CI 0.98~1.07)；尿路感染0.91(95%CI 0.85~0.98)。我们发现使用他汀类药物对呼吸道感染结果没有好处，尽管在未接种他汀类药物的患者中一致较高的OR可能表明他汀类药物和流感疫苗接种之间存在协同作用。
Statins reduce cardiovascular mortality and related risks associated with pneumonia suggesting potentially beneficial use in influenza pandemics. We investigated the effect of current statin use on acute respiratory infections in primary care. Data from anonymized electronic medical records of persons aged >= 45 years were examined for statin use, chronic morbidity, respiratory diagnoses, vaccination procedures, and immune suppression. Logistic regression models were used to calculate odds ratios (ORs) for statin users vs. non-users in respiratory infection outcomes. A total of 329 881 person-year observations included 18% statin users and 46% influenza vaccinees. Adjusted ORs for statin users vs. non-users were: influenza-like illness, 1.05 (95% CI 0.92-1.20); acute bronchitis, 1.08 (95% CI 1.01-1.15); pneumonia, 0.91 (95% CI 0.73-1.13); all acute respiratory infections, 1.03 (95% CI 0.98-1.07); and urinary tract infections, 0.91 (95 % CI 0.85-0.98). We found no benefit in respiratory infection outcomes attributable to statin use, although uniformly higher ORs in non-vaccinated statin users might suggest synergism between statins and influenza vaccination.