Department of Medicine, University of Auckland, Auckland, New Zealand.
Postgrad Med J. 2009 Aug;85(1006):414-21. doi: 10.1136/pgmj.2008.078477.
Studies show reduced forced expiratory volume in 1 s (FEV(1)) in patients with chronic obstructive pulmonary disease (COPD) is an important independent predictor of cardiovascular death and is characterised by both pulmonary and systemic inflammation. Evidence shows statins have important anti-inflammatory effects in both the lungs and arteries. Although randomised control trials are yet to be reported, non-randomised studies have consistently shown benefit in COPD patients taking statins compared with those not. These include reductions in both cardiovascular and respiratory morbidity/mortality. Other potential benefits include a reduced decline in FEV(1) and reduced risk of lung cancer. It is argued that confounding by a "healthy user effect" is unlikely to explain the observed benefit. Given the undisputed benefit of statins in high risk populations and the growing body of data suggesting statins may benefit patients with COPD, the question arises "Should statins be considered more often in patients with COPD?".
研究表明，慢性阻塞性肺疾病（COPD）患者的 1 秒用力呼气量（FEV1）降低是心血管死亡的重要独立预测因子，其特征是肺部和全身炎症。有证据表明，他汀类药物在肺部和动脉中均具有重要的抗炎作用。尽管尚未报告随机对照试验，但非随机研究一致表明，与未服用他汀类药物的 COPD 患者相比，服用他汀类药物的 COPD 患者获益。这些获益包括心血管和呼吸道发病率/死亡率的降低。其他潜在益处包括 FEV1 下降减少和肺癌风险降低。有人认为，混杂因素“健康使用者效应”不太可能解释观察到的获益。鉴于他汀类药物在高危人群中的无可争议的益处，以及越来越多的数据表明他汀类药物可能使 COPD 患者获益，因此出现了“是否应该更频繁地考虑在 COPD 患者中使用他汀类药物？”这一问题。
