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社区获得性肺炎患者的他汀类药物治疗。

Statin therapy in patients with community-acquired pneumonia.

机构信息

Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.

University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.

出版信息

Clin Med (Lond). 2017 Oct;17(5):403-407. doi: 10.7861/clinmedicine.17-5-403.

DOI:10.7861/clinmedicine.17-5-403
PMID:28974587
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6301923/
Abstract

Community-acquired pneumonia (CAP) is the leading cause of death from infection in developed countries. There is evidence of an association between improved survival from infection and statin use. The possible beneficial effects of statins are complicated by the common use of macrolide antibiotics for pneumonia, with current guidance suggesting that concurrent macrolide and statin use is contraindicated.We conducted an observational study of statin use in patients with CAP. Of 2,067 patients with CAP, 30.4% were on statin therapy at admission. Statin users were more likely to survive the admission (p<0.001). In addition, we conducted a survey of doctors and found that knowledge regarding concurrent macrolide and statin use was lacking.These data suggest a potential role of statins in the management of CAP. Further research using high-dose statins is required to assess their safe use in subjects with mild to moderate infections.

摘要

社区获得性肺炎(CAP)是发达国家感染相关死亡的主要原因。有证据表明,他汀类药物的使用与感染后生存率的提高之间存在关联。他汀类药物的可能有益作用因肺炎常用大环内酯类抗生素而变得复杂,目前的指南建议同时使用大环内酯类药物和他汀类药物是禁忌的。我们对 CAP 患者使用他汀类药物进行了一项观察性研究。在 2067 例 CAP 患者中,30.4%的患者在入院时接受他汀类药物治疗。他汀类药物使用者更有可能在入院期间存活(p<0.001)。此外,我们还对医生进行了一项调查,发现他们对同时使用大环内酯类药物和他汀类药物的知识存在不足。这些数据表明他汀类药物在 CAP 管理中的潜在作用。需要使用高剂量他汀类药物进行进一步研究,以评估它们在轻度至中度感染患者中的安全使用。

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Repurposing Treatments to Enhance Innate Immunity. Can Statins Improve Neutrophil Functions and Clinical Outcomes in COPD?重新利用治疗方法以增强固有免疫。他汀类药物能否改善慢性阻塞性肺疾病患者的中性粒细胞功能及临床结局?
J Clin Med. 2016 Oct 11;5(10):89. doi: 10.3390/jcm5100089.
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Is There Potential for Repurposing Statins as Novel Antimicrobials?他汀类药物能否被重新用作新型抗菌药物?
Antimicrob Agents Chemother. 2016 Aug 22;60(9):5111-21. doi: 10.1128/AAC.00192-16. Print 2016 Sep.
3
Statins Reduce Mortality After Non-severe but Not After Severe Pneumonia: A Systematic Review and Meta-Analysis.他汀类药物可降低非重症肺炎后的死亡率,但对重症肺炎无效:一项系统评价和荟萃分析。
J Pharm Pharm Sci. 2015;18(3):286-302. doi: 10.18433/j34307.
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The effect of simvastatin on inflammatory cytokines in community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial.辛伐他汀对社区获得性肺炎炎症细胞因子的影响:一项随机、双盲、安慰剂对照试验。
BMJ Open. 2015 Jan 6;5(1):e006251. doi: 10.1136/bmjopen-2014-006251.
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Statins for sepsis: distinguishing signal from the noise when designing clinical trials.用于脓毒症的他汀类药物:设计临床试验时区分信号与噪声。
Am J Respir Crit Care Med. 2013 Oct 1;188(7):874. doi: 10.1164/rccm.201302-0392LE.
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