Onofrei Mihai Daniel, Butler Kristina L, Fuke Dawn C, Miller Heather B
Providence Physician Division, Milwaukie, OR 97222, USA.
Pharmacotherapy. 2008 Apr;28(4):522-9. doi: 10.1592/phco.28.4.522.
Cardiovascular disease is the leading cause of mortality in the United States. In high-risk patients, statin therapy has become the standard of care. In fact, statins are the most efficacious drugs for decreasing low-density lipoprotein cholesterol levels; they reduce both primary and secondary cardiovascular risk in the general population. However, less is known about the safety of statin use in patients with liver disease. Results from studies of statin therapy in patients with elevated liver enzyme levels, nonalcoholic fatty liver disease, hepatitis C, cirrhosis, liver transplants, and hepatocellular carcinoma show benefit without increased risk of adverse effects. Thus, based on available evidence, statin therapy should not be withheld in this patient population; however, more robust, prospective clinical trials are needed to confirm the safety and efficacy.
心血管疾病是美国的主要死因。在高危患者中，他汀类药物治疗已成为标准治疗方法。事实上，他汀类药物是降低低密度脂蛋白胆固醇水平最有效的药物；它们降低了普通人群的一级和二级心血管疾病风险。然而，对于肝病患者使用他汀类药物的安全性了解较少。对肝酶水平升高、非酒精性脂肪性肝病、丙型肝炎、肝硬化、肝移植和肝细胞癌患者进行他汀类药物治疗的研究结果显示，使用他汀类药物有益，且不会增加不良反应的风险。因此，根据现有证据，不应拒绝在这一患者群体中使用他汀类药物治疗；然而，需要更有力的前瞻性临床试验来证实其安全性和有效性。
