From the *Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY; and †Department of Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY.
Cardiol Rev. 2013 Nov-Dec;21(6):295-9. doi: 10.1097/CRD.0b013e31829cae2d.
Statins have dramatically improved the treatment of hyperlipidemia and cardiovascular disease through its inhibition of hydroxymethylglutaryl-coenzyme A reductase. Although its main effect has long been known, much is yet to be understood about the wide and varied pleiotropic properties of statins. Some studies have demonstrated that statins contain antiplatelet, antithrombotic, antiinflammatory, cardioprotective, and neuroprotective properties independent of their ability to lower plasma low-density lipoprotein cholesterol. More recently, statins have been used in novel ways in the treatment of Alzheimer disease, sepsis, pneumonia, and bacteremia. In 2000, it was first suggested that statins could decrease the incidence of venous thromboembolisms (VTEs). A recent publication showed that not only do statins lower the incidence of deep vein thrombosis and pulmonary embolism, but they do so in a dose-dependent manner. Although there is certainly strong evidence demonstrating that statins do indeed lower VTEs, the mechanism is not understood. Possible hypotheses include their antiinflammatory and antithrombotic properties. With only one randomized clinical trial available, further studies must be conducted before routinely recommending statins for prophylaxis of VTEs.
他汀类药物通过抑制羟甲基戊二酰辅酶 A 还原酶，显著改善了高脂血症和心血管疾病的治疗效果。尽管其主要作用早已为人所知，但人们对他汀类药物广泛而多样的多效性特性仍有很多不了解。一些研究表明，他汀类药物具有抗血小板、抗血栓、抗炎、心脏保护和神经保护作用，而不依赖于降低血浆低密度脂蛋白胆固醇的能力。最近，他汀类药物在治疗阿尔茨海默病、脓毒症、肺炎和菌血症方面被以新的方式使用。2000 年，首次有人提出他汀类药物可能降低静脉血栓栓塞症（VTE）的发生率。最近的一项研究表明，他汀类药物不仅降低了深静脉血栓形成和肺栓塞的发生率，而且呈剂量依赖性。尽管有强有力的证据表明他汀类药物确实可以降低 VTE 的发生率，但机制尚不清楚。可能的假设包括它们的抗炎和抗血栓形成特性。由于只有一项随机临床试验可用，因此在常规推荐他汀类药物预防 VTE 之前，必须进行更多的研究。
