University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, Maryland 21201, USA.
COPD. 2011 Apr;8(2):96-102. doi: 10.3109/15412555.2011.558545.
Pulmonary hypertension (PH) in COPD carries a poor prognosis. Statin therapy has been associated with numerous beneficial clinical effects in COPD, including a possible improvement in PH. We examined the association between statin use and pulmonary hemodynamics in a well-characterized cohort of patients undergoing evaluation for lung transplantation.
We conducted a cross-sectional analysis of 112 subjects evaluated for lung transplant with a diagnosis of COPD. Clinical characteristics, pulmonary function, cardiac catheterization findings and medical comorbidities were compared between statins users and non-users.
Thirty-four (30%) subjects were receiving statin therapy. Statin users were older and had an increased prevalence of systemic hypertension and coronary artery disease (CAD). Mean pulmonary arterial pressure (mPAP) in the statin group was lower [26 ± 7 vs 29 ± 7 mmHg, p = 0.02], as was pulmonary artery wedge pressure (PAWP) [12 ± 5 vs. 15 ± 6 mmHg, p = 0.02]. Pulmonary vascular resistance did not differ between the groups. In multiple regression analysis, statin use was associated with a 4.2 mmHg (95% CI: 2 to 6.4, p = <0.001) lower PAWP and a 2.6 mmHg (95% CI: 0.3 to 4.9, p = 0.03) reduction in mPAP independent of PAWP.
In patients with severe COPD, statin use is associated with significantly lower PAWP and mPAP. These finding should be evaluated prospectively.
COPD 合并肺动脉高压（PH）预后不良。他汀类药物治疗与 COPD 的许多有益的临床效果相关，包括可能改善 PH。我们在一组经过充分特征描述的接受肺移植评估的患者中，研究了他汀类药物使用与肺血液动力学之间的关系。
我们对 112 例诊断为 COPD 并接受肺移植评估的患者进行了横断面分析。比较了他汀类药物使用者和非使用者的临床特征、肺功能、心导管检查结果和合并症。
34 例（30%）患者正在接受他汀类药物治疗。他汀类药物使用者年龄较大，且更常见高血压和冠状动脉疾病（CAD）。他汀组的平均肺动脉压（mPAP）[26 ± 7 比 29 ± 7mmHg，p = 0.02]和肺动脉楔压（PAWP）[12 ± 5 比 15 ± 6mmHg，p = 0.02]均较低。两组的肺血管阻力无差异。多元回归分析显示，他汀类药物使用与 PAWP 降低 4.2mmHg（95%CI：2 至 6.4mmHg，p <0.001）和 mPAP 降低 2.6mmHg（95%CI：0.3 至 4.9mmHg，p = 0.03）独立相关，而与 PAWP 无关。
在严重 COPD 患者中，他汀类药物使用与明显较低的 PAWP 和 mPAP 相关。这些发现应进行前瞻性评估。
