Department of Medicine, Rochester General Hospital, Rochester, New York, USA.
Ann Allergy Asthma Immunol. 2009 Dec;103(6):463-8. doi: 10.1016/S1081-1206(10)60261-X.
3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors have significantly improved outcomes in coronary artery disease. They have anti-inflammatory and cholesterol-lowering effects. Statins alter the production of T(H)1 cytokines and thus promote a T(H)2 response. This immune alteration would promote allergic diseases such as asthma.
To ascertain whether statin use adversely affects the clinical course of asthma.
We retrospectively reviewed 759 medical records of consecutive patients with asthma to identify patients with extrinsic asthma who had at least 4 physician visits over 1 year. We compared patients who started receiving statins after their initial asthma evaluation with patients who never received statins. Baseline characteristics; change in forced expiratory volume in 1 second from baseline at 3, 6, 12, and 24 months; and a need for increases in medication and acute asthma visits were compared between the statin and control groups.
We identified 24 patients who started statin therapy and 26 control patients. There was a statistically significant 3% to 5% median worsening of forced expiratory volume in 1 second at all time points for the statin group compared with the controls. At 6 months, more patients in the statin group needed increased maintenance medication (16 [67%] vs 7 [27%]; P = .005), used albuterol more frequently (18 [75%] vs 3 [12%]; P < .001), had more nocturnal awakenings (8 [33%] vs 0 [0%]; P < .001), and were seen more frequently at office visits for acute asthma (9 [38%] vs 1 [4%]; P = .003).
This preliminary study demonstrated that patients with asthma who received statins had a worse clinical course than controls. Given the prevalence of both statin use and asthma, further research is needed.
3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂显著改善了冠状动脉疾病的预后。它们具有抗炎和降低胆固醇的作用。他汀类药物改变 T(H)1 细胞因子的产生，从而促进 T(H)2 反应。这种免疫改变会促进哮喘等过敏性疾病。
确定他汀类药物的使用是否对哮喘的临床病程产生不利影响。
我们回顾性分析了 759 例连续就诊的哮喘患者的病历，以确定具有至少 4 次 1 年以上就诊记录的外源性哮喘患者。我们比较了初始哮喘评估后开始接受他汀类药物治疗的患者和从未接受过他汀类药物治疗的患者。比较了他汀组和对照组的基线特征；第 3、6、12 和 24 个月时从基线到第 1 秒用力呼气量的变化；以及药物增加和急性哮喘就诊的需要。
我们确定了 24 例开始他汀类药物治疗的患者和 26 例对照患者。他汀组在所有时间点的第 1 秒用力呼气量中位数均有 3%至 5%的显著恶化，而对照组则无。在 6 个月时，他汀组有更多的患者需要增加维持药物（16 [67%] vs 7 [27%]；P =.005），更频繁地使用沙丁胺醇（18 [75%] vs 3 [12%]；P <.001），更多的夜间觉醒（8 [33%] vs 0 [0%]；P <.001），以及因急性哮喘就诊的次数更多（9 [38%] vs 1 [4%]；P =.003）。
这项初步研究表明，接受他汀类药物治疗的哮喘患者的临床病程比对照组差。鉴于他汀类药物的使用和哮喘的普遍性，需要进一步研究。
