Department of Internal Medicine, Division of General Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109-5429, USA.
Am J Med. 2012 Nov;125(11):1111-23. doi: 10.1016/j.amjmed.2012.04.011. Epub 2012 Jul 24.
The objective of this study was to perform a systematic review and meta-analysis of the effects of statins on mortality following pneumonia.
We searched MEDLINE, EMBASE, BIOSIS, Cochrane CENTRAL Register of Controlled Trials, Cambridge Scientific Abstracts, BIOSIS, and Scopus. Studies were included if they involved: participants ≥18 years of age; patients with community-acquired pneumonia; current statin users; and reported overall or adjusted mortality after pneumonia.
Of 491 citations identified, 13 studies involving 254,950 patients met eligibility criteria. Pooled unadjusted data showed that statin use was associated with lower mortality after pneumonia (odds ratio [OR] 0.62, 95% confidence interval [CI], 0.54-0.71). Pooling of adjusted data also showed reduced mortality after pneumonia (OR 0.66, 95% CI, 0.55-0.79). However, this effect was attenuated in subgroup analysis by confounders and in prospective studies.
Although statin use is associated with decreased mortality after pneumonia, this effect weakens in important subgroups. Only a randomized controlled study can fully explore the link between statins and pneumonia mortality.
本研究旨在对他汀类药物治疗肺炎后死亡率的影响进行系统评价和荟萃分析。
我们检索了 MEDLINE、EMBASE、BIOSIS、Cochrane 对照试验中心注册库、剑桥科学文摘、BIOSIS 和 Scopus。纳入的研究需满足以下条件：参与者年龄≥18 岁；患者为社区获得性肺炎；当前他汀类药物使用者；报告肺炎后总死亡率或校正死亡率。
在 491 篇引用文献中，有 13 项研究纳入了 254950 名患者，符合入选标准。未校正数据的荟萃分析显示，使用他汀类药物与肺炎后死亡率降低相关（比值比[OR]0.62，95%置信区间[CI]0.54-0.71）。校正数据的荟萃分析也显示肺炎后死亡率降低（OR 0.66，95% CI 0.55-0.79）。然而，在亚组分析中，混杂因素和前瞻性研究削弱了这种效应。
尽管他汀类药物的使用与肺炎后死亡率降低相关，但这种效应在重要亚组中减弱。只有随机对照试验才能充分探讨他汀类药物与肺炎死亡率之间的联系。
