Yeh Jun-Jun, Lin Cheng-Li, Hsu Chung-Y, Shae Zonyin, Kao Chia-Hung
Department of Family and Chest Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan.
Department of Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
J Clin Med. 2018 Oct 24;7(11):381. doi: 10.3390/jcm7110381.
We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma⁻chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000⁻2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34⁻0.70] and pneumonia (aHR 0.52, 95% CI 0.41⁻0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31⁻1.16) and 0.58 (0.40⁻0.85) for TB and 0.61 (0.39⁻0.95) and 0.57 (0.45⁻0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs.
我们研究了他汀类药物对哮喘-慢性肺病重叠综合征（ACOS）患者患结核病（TB）和肺炎风险的影响。我们从台湾国民健康保险研究数据库中提取了2000年至2010年期间被诊断为患有ACOS的患者数据，并将他们分为他汀类药物使用者和非使用者。所有研究参与者从索引日期开始随访，直至死亡、退出保险或发生结核病和肺炎（2011年12月31日）。使用具有时间依赖性变量的Cox比例回归分析来分析结核病和肺炎的累积发病率。在对包括年龄、性别、合并症以及药物使用情况[他汀类药物、吸入性糖皮质激素（ICSs）或口服类固醇（OSs）]等多个混杂因素进行调整后，使用他汀类药物与显著降低的结核病[调整后风险比（aHR）0.49，95%置信区间（CI）0.34至0.70]和肺炎（aHR 0.52，95%CI 0.41至0.65）风险相关。此外，他汀类药物与ICSs和OSs联合使用时，结核病的aHR（95%CI）分别为0.60（0.31至1.16）和0.58（0.40至0.85），肺炎的aHR分别为0.61（0.39至0.95）和0.57（0.45至0.74）。因此，无论年龄、性别、合并症以及ICS或OS的使用情况如何，他汀类药物使用者患结核病和肺炎的风险均低于非使用者。他汀类药物与ICSs或OSs联合使用的使用者中肺炎风险较低，而他汀类药物与OSs联合使用的使用者中结核病风险较低。
