van de Garde E M W, Hak E, Souverein P C, Hoes A W, van den Bosch J M M, Leufkens H G M
Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmacoepidemiology and Pharmacotherapy, Sorbonnelaan 16, 3583 CA Utrecht, The Netherlands.
Thorax. 2006 Nov;61(11):957-61. doi: 10.1136/thx.2006.062885. Epub 2006 Jun 29.
Recent prognostic studies have shown that previous treatment with statins is associated with a better outcome in patients admitted to hospital with pneumonia. Because of an increased risk of pneumonia in patients with diabetes, we assessed the effects of statin use on the occurrence of pneumonia in adult diabetic patients.
All patients with a diagnosis of diabetes (types 1 and 2) enlisted in the UK General Practice Research Database between 1 June 1987 and 21 January 2001 were included. A case-control study was performed with cases defined as patients with a first recorded diagnosis of pneumonia. For each case up to four controls were matched by age, sex, practice, and index date. Patients were classified as current users when the index date was between the start and end date of statin treatment. Conditional multiple logistic regression analysis was used to estimate the strength of the association between statin treatment and the occurrence of pneumonia.
Statins were used in 1.1% of 4719 cases and in 2.1% of 15 322 matched controls (crude odds ratio (OR) 0.51, 95% CI 0.37 to 0.68). After adjusting for potential confounders, treatment with statins was associated with a significant reduction in the risk of pneumonia (adjusted OR 0.49, 95% CI 0.35 to 0.69). The association was consistent among relevant subgroups (cardiovascular diseases, pulmonary diseases) and independent of the use of other prescription drugs.
The use of statins is associated with a considerable reduction in the risk of pneumonia in diabetic patients. In addition to lowering the risk of cardiovascular disease, statins may be useful in preventing respiratory infections.
近期的预后研究表明,他汀类药物的既往治疗与肺炎住院患者更好的预后相关。由于糖尿病患者发生肺炎的风险增加,我们评估了他汀类药物使用对成年糖尿病患者肺炎发生的影响。
纳入1987年6月1日至2001年1月21日在英国全科医学研究数据库中登记的所有1型和2型糖尿病患者。进行了一项病例对照研究,病例定义为首次记录诊断为肺炎的患者。对于每个病例,按年龄、性别、医疗机构和索引日期匹配最多4名对照。当索引日期在他汀类药物治疗的开始和结束日期之间时,患者被分类为当前使用者。采用条件多因素logistic回归分析来估计他汀类药物治疗与肺炎发生之间关联的强度。
4719例病例中有1.1%使用了他汀类药物,15322名匹配对照中有2.1%使用了他汀类药物(粗比值比(OR)为0.51,95%可信区间为0.37至0.68)。在对潜在混杂因素进行校正后,他汀类药物治疗与肺炎风险显著降低相关(校正OR为0.49,95%可信区间为0.35至0.69)。该关联在相关亚组(心血管疾病、肺部疾病)中一致,且独立于其他处方药的使用。
他汀类药物的使用与糖尿病患者肺炎风险的显著降低相关。除了降低心血管疾病风险外,他汀类药物可能有助于预防呼吸道感染。