他汀类药物在急性胰腺炎和有症状的胆石病患者中的应用。

Statin use in patients with acute pancreatitis and symptomatic gallstone disease.

机构信息

From the *Department of Surgery, Kuopio University Hospital; †School of Medicine, University of Eastern Finland, Kuopio; ‡Assessment of Pharmacotherapies, Finnish Medicines Agency, Kuopio; and §Department of Gastroenterology and Alimentary Track Disease, Tampere University Hospital, Tampere, Finland.

出版信息

Pancreas. 2014 May;43(4):638-41. doi: 10.1097/MPA.0000000000000068.

DOI:10.1097/MPA.0000000000000068

PMID:24632548

Abstract

OBJECTIVE

The long-term use of statins may be associated with a decreased risk for gallstones and biliary-induced acute pancreatitis (AP). Our aim was to study the relationship of statin use and outcome of AP.

METHODS

We investigated the records of 461 consecutive patients with AP and 1140 patients with symptomatic gallstones during 2008 to 2010. The use of lipid-lowering drugs, patient's characteristics, and outcome of patients were recorded. All known risk factors for AP and particularly statin use in idiopathic AP were analyzed.

RESULTS

Statin use was comparable between the patients with AP (22%) and patients with cholelithiasis (24%). The frequencies of surgical treatment, duration of hospital stay, or mortality were not different between the statin users compared with the nonusers. Idiopathic AP was more often associated with the use of statins than alcohol- or gallstone-induced AP (44% vs 30% vs 13%, P < 0.002). The etiology of AP was alcohol in 56% of the patients, gallstones in 28% of the patients, and unknown (idiopathic) or miscellaneous in 16% of the patients.

CONCLUSIONS

No beneficial effect of statins was observed in mortality or other outcome parameters of patients with AP. Statin use was more frequent in patients with idiopathic AP than in patients with biliary- or alcohol-induced AP.

摘要

目的

长期使用他汀类药物可能与降低胆结石和胆源性急性胰腺炎（AP）的风险有关。我们的目的是研究他汀类药物的使用与 AP 结局之间的关系。

方法

我们调查了 2008 年至 2010 年间连续 461 例 AP 患者和 1140 例有症状胆结石患者的记录。记录了降脂药物的使用、患者特征以及患者的结局。分析了所有已知的 AP 风险因素，特别是特发性 AP 中的他汀类药物使用情况。

结果

AP 患者（22%）和胆结石患者（24%）使用他汀类药物的比例相当。与非使用者相比，他汀类药物使用者的手术治疗频率、住院时间或死亡率没有差异。与酒精或胆石性 AP 相比，特发性 AP 更常与他汀类药物的使用相关（44%比 30%比 13%，P < 0.002）。AP 的病因在 56%的患者中为酒精，在 28%的患者中为胆结石，在 16%的患者中为未知（特发性）或其他原因。