Biccard B M
Nelson R Mandela School of Medicine, Private Bag 7, Congella, 4013, South Africa.
Anaesthesia. 2008 Feb;63(2):162-71. doi: 10.1111/j.1365-2044.2007.05265.x.
This is the second of two review articles evaluating peri-operative statin therapy. In surgical patients, the utility of peri-operative statin therapy is strongly suggested by retrospective studies, although it is probably overestimated, as important confounding factors have not been controlled for and hence the literature is considered to be currently inconclusive. This review examines the potential mechanisms and indications for peri-operative statin protection, the efficacy of acute peri-operative beta-blockade in addition to statin therapy, the effect of peri-operative statin therapy withdrawal and the implications of comorbidities associated with peri-operative cardiovascular risk on statin therapy. Recommendations concerning appropriate dosing, duration, therapeutic targets and necessary investigations when prescribing peri-operative statins are made. Peri-operative study design recommendations are suggested, so that future meta-analyses may be more informative. Recommendations are made regarding retrospective reporting of statin studies to minimise the bias inherent in a number of the current retrospective studies on this subject.
这是两篇评估围手术期他汀类药物治疗的综述文章中的第二篇。在外科手术患者中，回顾性研究强烈提示围手术期他汀类药物治疗的效用，尽管其可能被高估了，因为重要的混杂因素未得到控制，因此目前认为该文献尚无定论。本综述探讨了围手术期他汀类药物保护的潜在机制和适应证、除他汀类药物治疗外急性围手术期β受体阻滞剂的疗效、围手术期他汀类药物治疗停药的影响以及与围手术期心血管风险相关的合并症对他汀类药物治疗的影响。针对围手术期开具他汀类药物时的适当剂量、疗程、治疗靶点和必要检查提出了建议。提出了围手术期研究设计建议，以便未来的荟萃分析可能提供更多信息。针对他汀类药物研究的回顾性报告提出了建议，以尽量减少当前关于该主题的一些回顾性研究中固有的偏差。
