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他汀类药物与肺炎风险:一项基于人群的巢式病例对照研究。

Statins and the risk of pneumonia: a population-based, nested case-control study.

作者信息

Schlienger Raymond G, Fedson David S, Jick Susan S, Jick Hershel, Meier Christoph R

机构信息

Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland.

出版信息

Pharmacotherapy. 2007 Mar;27(3):325-32. doi: 10.1592/phco.27.3.325.

Abstract

STUDY OBJECTIVE

To determine if the use of statins affects pneumonia-related outpatient visits, hospitalizations with survival, and deaths.

DESIGN

Population-based, retrospective, nested case-control analysis.

DATA SOURCE

United Kingdom-based General Practice Research Database.

PARTICIPANTS

The study population (134,262 patients aged > or = 30 yrs) consisted of 55,118 patients who took statins and/or fibrates, 29,144 patients with hyperlipidemia not taking lipid-lowering agents, and 50,000 randomly selected patients without hyperlipidemia and without lipid-lowering treatment.

MEASUREMENTS AND MAIN RESULTS

We identified 1253 patients with pneumonia and matched them with 4838 control subjects based on age, sex, general practice, and index date. After adjusting for comorbidity and frequency of visits to general practitioners, we calculated the risks (odds ratios with 95% confidence intervals) of uncomplicated pneumonia, hospitalization for pneumonia with survival, and fatal pneumonia in participants who used statins compared with those who did not. Current statin users had a significantly reduced risk of fatal pneumonia (adjusted odds ratio 0.47, 95% confidence interval 0.25-0.88) and slightly but not significantly reduced risks of uncomplicated pneumonia and pneumonia hospitalization with survival. Recent or past statin use and fibrate use at any time were not associated with a reduced risk of pneumonia.

CONCLUSION

Current use of statins was associated with a reduced risk of pneumonia. The risk reduction was particularly strong in the subgroup of patients with fatal pneumonias.

摘要

研究目的

确定使用他汀类药物是否会影响与肺炎相关的门诊就诊、存活患者的住院情况以及死亡情况。

设计

基于人群的回顾性巢式病例对照分析。

数据来源

英国全科医学研究数据库。

研究对象

研究人群(134262名年龄≥30岁的患者)包括55118名服用他汀类药物和/或贝特类药物的患者、29144名未服用降脂药物的高脂血症患者以及50000名随机选取的无高脂血症且未接受降脂治疗的患者。

测量指标及主要结果

我们识别出1253例肺炎患者,并根据年龄、性别、全科医疗情况和索引日期将他们与4838名对照者进行匹配。在调整了合并症和就诊于全科医生的频率后,我们计算了使用他汀类药物的参与者与未使用者相比,发生非复杂性肺炎、存活患者因肺炎住院以及致命性肺炎的风险(比值比及95%置信区间)。当前使用他汀类药物的患者发生致命性肺炎的风险显著降低(调整后比值比0.47,95%置信区间0.25 - 0.88),发生非复杂性肺炎以及存活患者因肺炎住院的风险略有降低但不显著。近期或过去使用他汀类药物以及任何时候使用贝特类药物与肺炎风险降低无关。

结论

当前使用他汀类药物与肺炎风险降低相关。在致命性肺炎患者亚组中,风险降低尤为明显。

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