The First Hospital of Lanzhou University, Lanzhou, Gansu, People's Republic of China.
Lanzhou Maternal and Child Health Care Hospital, Lanzhou, Gansu, 730000, People's Republic of China.
Respir Res. 2019 Jan 23;20(1):17. doi: 10.1186/s12931-019-0984-3.
To evaluate the effectiveness of long-term treatment of statins for chronic obstructive pulmonary disease (COPD), and to answer which one is better.
General meta-analysis was performed to produce polled estimates of the effect of mortality, inflammatory factors, and lung function index in COPD patients by the search of PubMed, Web of Science, Embase, and China National Knowledge Infrastructure for eligible studies. A network meta-analysis was performed to synthetically compare the effectiveness of using different statins in COPD patients.
General meta-analysis showed that using statins reduced the risk of all-cause mortality, heart disease-related mortality and COPD acute exacerbation (AECOPD) in COPD patients, the RR (95% CI) were 0.72 (0.63,0.84), 0.72 (0.53,0.98) and 0.84 (0.79,0.89), respectively. And using statins reduced C-reactive protein (CRP) and pulmonary hypertension (PH) in COPD patients, the SMD (95% CI) were - 0.62 (- 0.52,-0.72) and - 0.71 (- 0.85,-0.57), respectively. Network meta-analysis showed that Fluvastatin (97.7%), Atorvastatin (68.0%) and Rosuvastatin (49.3%) had higher cumulative probability than other statins in reducing CRP in COPD patients. Fluvastatin (76.0%) and Atorvastatin (75.4%) had higher cumulative probability than other satins in reducing PH in COPD patients.
Using statins can reduce the risk of mortality, the level of CRP and PH in COPD patients. In addition, Fluvastatin and Atorvastatin are more effective in reducing CRP and PH in COPD patients.
评估他汀类药物长期治疗慢性阻塞性肺疾病(COPD)的效果,并回答哪种药物效果更好。
通过检索 PubMed、Web of Science、Embase 和中国知网,进行一般荟萃分析,以产生他汀类药物对 COPD 患者死亡率、炎症因子和肺功能指标影响的合并估计值。进行网络荟萃分析,综合比较不同他汀类药物在 COPD 患者中的疗效。
一般荟萃分析显示,他汀类药物可降低 COPD 患者全因死亡率、心脏病相关死亡率和 COPD 急性加重(AECOPD)的风险,RR(95%CI)分别为 0.72(0.63,0.84)、0.72(0.53,0.98)和 0.84(0.79,0.89)。他汀类药物还可降低 COPD 患者的 C 反应蛋白(CRP)和肺动脉高压(PH),SMD(95%CI)分别为-0.62(-0.52,-0.72)和-0.71(-0.85,-0.57)。网络荟萃分析显示,在降低 COPD 患者 CRP 方面,氟伐他汀(97.7%)、阿托伐他汀(68.0%)和罗苏伐他汀(49.3%)比其他他汀类药物具有更高的累积概率。在降低 COPD 患者 PH 方面,氟伐他汀(76.0%)和阿托伐他汀(75.4%)比其他他汀类药物具有更高的累积概率。
使用他汀类药物可降低 COPD 患者的死亡率、CRP 和 PH 水平。此外,氟伐他汀和阿托伐他汀在降低 COPD 患者的 CRP 和 PH 方面更有效。