Batais Mohammed A, Khan Abdur Rahman, Bin Abdulhak Aref A
College of Medicine, King Saud University, Riyadh, 29391, Saudi Arabia.
Department of Medicine, Division of Cardiovascular Diseases, University of Louisville, Louisville, KY, USA.
Curr Infect Dis Rep. 2017 Aug;19(8):26. doi: 10.1007/s11908-017-0581-x.
Community-acquired pneumonia (CAP) is still associated with a large burden and causes significant morbidity and mortality. Besides universal vaccination and antibiotic treatment, statins as adjunctive therapy may also have a beneficial role in the prevention and treatment of CAP. Our goal from this review is to discuss the epidemiology of CAP, and role of statins as adjunctive therapy in the development of CAP.
Statins are lipid-lowering medications characterized by their ability to control hypercholesterolemia in addition to other pleiotropic effects that could explain their role in the pathogenesis of CAP. While most observational studies have shown that statins reduce risk of pneumonia in the general population, patients with diabetes, and recently in patients with myocardial infarction, no randomized controlled trial (RCT) to date has been conducted to assess the efficacy of statins to prevent development of CAP. Given the paucity of robust randomized evidence to assess statin use and the development of CAP, and considering conflicting results of the observational studies, we are not in favor of initiation of statins for either the prevention or treatment of CAP.
社区获得性肺炎(CAP)仍然负担沉重,会导致显著的发病率和死亡率。除了普遍接种疫苗和抗生素治疗外,他汀类药物作为辅助治疗在CAP的预防和治疗中可能也具有有益作用。本综述的目的是讨论CAP的流行病学以及他汀类药物作为辅助治疗在CAP发生发展中的作用。
他汀类药物是降血脂药物,除了能够控制高胆固醇血症外,还具有其他多种有益作用,这可以解释它们在CAP发病机制中的作用。虽然大多数观察性研究表明,他汀类药物可降低普通人群、糖尿病患者以及近期心肌梗死患者发生肺炎的风险,但迄今为止尚未进行随机对照试验(RCT)来评估他汀类药物预防CAP发生的疗效。鉴于评估他汀类药物使用与CAP发生发展的有力随机证据匮乏,且考虑到观察性研究结果相互矛盾,我们不支持使用他汀类药物预防或治疗CAP。