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他汀类药物:败血症的万灵药?

Statins: panacea for sepsis?

作者信息

Terblanche Marius, Almog Yaniv, Rosenson Robert S, Smith Terry S, Hackam Daniel G

机构信息

Interdepartmental Division of Critical Care Medicine, Sunnybrook and Women's College Health Science Centre, Toronto, Canada.

出版信息

Lancet Infect Dis. 2006 Apr;6(4):242-8. doi: 10.1016/S1473-3099(06)70439-X.

Abstract

Sepsis occurs when the immune system responds to a localised infection at a systemic level, thereby causing tissue damage and organ dysfunction. Statins have proven health benefits in many diseases involving vascular inflammation and injury. Recent animal data suggest that the administration of a statin before a sepsis-inducing insult reduces morbidity and improves survival. The immunomodulatory and anti-inflammatory effects of statins, collectively referred to as pleiotropic effects, lend biological plausibility to such findings. Limited human data hint at reduced mortality rates in bacteraemic patients, and a reduced risk of sepsis in patients with bacterial infections concurrently taking statins. These lines of evidence point to a potential new treatment and prevention modality for sepsis. The stage is set for randomised controlled clinical trials that will determine whether statins represent a safe and beneficial treatment in critically ill, septic patients and whether statins are effective at preventing sepsis in high-risk clinical settings.

摘要

当免疫系统对局部感染产生全身性反应时,就会发生脓毒症,从而导致组织损伤和器官功能障碍。他汀类药物已被证明对许多涉及血管炎症和损伤的疾病具有健康益处。最近的动物数据表明,在引发脓毒症的损伤之前给予他汀类药物可降低发病率并提高生存率。他汀类药物的免疫调节和抗炎作用,统称为多效性作用,为这些发现提供了生物学合理性。有限的人类数据表明菌血症患者的死亡率降低,同时服用他汀类药物的细菌感染患者发生脓毒症的风险降低。这些证据表明脓毒症可能有新的治疗和预防方式。随机对照临床试验即将开展,以确定他汀类药物对重症脓毒症患者是否是一种安全有益的治疗方法,以及他汀类药物在高风险临床环境中预防脓毒症是否有效。

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