非心脏手术围手术期他汀类药物的应用。
Perioperative use of statins in noncardiac surgery.
作者信息
Chan Y C, Cheng S W, Irwin M G
机构信息
Division of Vascular Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
出版信息
Vasc Health Risk Manag. 2008;4(1):75-81. doi: 10.2147/vhrm.2008.04.01.75.
BACKGROUND
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) can significantly decrease cardiovascular mortality and morbidity, irrespective of the patients' cholesterol status. This paper reviews the effects of perioperative statin therapy in patients undergoing noncardiac surgery.
METHOD
A systematic literature review was undertaken of all published literature on this subject using Medline and cross-referenced. All published relevant papers on the perioperative use of statins were used.
RESULTS
Perioperative statin therapy is associated with a lower perioperative morbidity and mortality in patients undergoing elective or emergency surgery. The effects are due to a combination of lipid-lowering and pleiotropic properties of statins.
CONCLUSION
Ideally a large scale multi-centre randomized controlled trial of perioperative statin therapy should be performed but this may be difficult to conduct since there is already overwhelming evidence in the literature to suggest perioperative cardiovascular protective properties. Statins may still be under-prescribed in surgical patients.
背景
他汀类药物（3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂）可显著降低心血管疾病的死亡率和发病率，无论患者的胆固醇水平如何。本文综述了围手术期他汀类药物治疗对接受非心脏手术患者的影响。
方法
使用Medline对所有关于该主题的已发表文献进行系统的文献综述，并进行交叉引用。所有已发表的关于围手术期使用他汀类药物的相关论文均被采用。
结果
围手术期他汀类药物治疗与接受择期或急诊手术患者的围手术期发病率和死亡率降低相关。这些效果归因于他汀类药物的降脂特性和多效性的综合作用。
结论
理想情况下，应进行大规模多中心围手术期他汀类药物治疗的随机对照试验，但这可能难以实施，因为文献中已有大量证据表明围手术期他汀类药物具有心血管保护作用。他汀类药物在外科患者中的处方可能仍然不足。
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