Brookes Z L S, McGown C C, Reilly C S
Microcirculation Research Group, School of Medicine and Biomedical Sciences, Royal Hallamshire Hospital, University of Sheffield, K Floor, Beech Hill Road, Sheffield, UK.
Br J Anaesth. 2009 Jul;103(1):99-107. doi: 10.1093/bja/aep149. Epub 2009 Jun 5.
The use of statins is widespread and many patients presenting for surgery are regularly taking them. There is evidence that statins have beneficial effects beyond those of lipid lowering, including reducing the perioperative risk of cardiac complications and sepsis. This review addresses the cellular mechanisms by which statins may produce these effects. Statins appear to have actions on vascular nitric oxide through the balance of inducible and endothelial nitric oxide synthase. The clinical evidence for these benefits is also briefly reviewed with the objective of clarifying the current status of statin use in the perioperative period. There is reasonably strong evidence that patients already taking statins should continue on them perioperatively. However, the evidence for the prophylactic use of statins perioperatively is weak and lacks prospective controlled studies.
他汀类药物的使用非常广泛，许多接受手术的患者经常服用此类药物。有证据表明，他汀类药物除了具有降脂作用外，还有其他益处，包括降低围手术期心脏并发症和脓毒症的风险。本综述探讨了他汀类药物产生这些作用的细胞机制。他汀类药物似乎通过诱导型一氧化氮合酶和内皮型一氧化氮合酶的平衡对血管一氧化氮产生作用。本文还简要回顾了这些益处的临床证据，目的是阐明他汀类药物在围手术期的使用现状。有相当充分的证据表明，已经在服用他汀类药物的患者在围手术期应继续用药。然而，围手术期预防性使用他汀类药物的证据不足，且缺乏前瞻性对照研究。
