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在美国具有全国代表性的样本中,他汀类药物的使用对慢性鼻-鼻窦炎具有保护作用。

Statin use protective for chronic rhinosinusitis in a nationally representative sample of the United States.

机构信息

Department of Otolaryngology, University of Virginia School of Medicine, Charlottesville, Virginia, U.S.A.

Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.

出版信息

Laryngoscope. 2020 Apr;130(4):848-851. doi: 10.1002/lary.28085. Epub 2019 May 31.

Abstract

OBJECTIVES/HYPOTHESIS: Statins have long been used in the management of cardiovascular disease for their lipid-lowering properties. However, recent research suggests that statins may also have anti-inflammatory effects via modulation of lipid-containing enzymes and mediators, and therefore may have therapeutic value in the treatment of chronic rhinosinusitis (CRS).

STUDY DESIGN

Retrospective database review.

METHODS

The 2006 to 2015 National Ambulatory Medical Care Survey (NAMCS) data were queried to analyze the relationship between statin use and rates of CRS. CRS was indicated by the presence of an International Classification of Diseases, Ninth Revision code for CRS in one of the five diagnosis variables. Statin use was indicated by the presence of a statin medication in any of the 30 medication variables using the Multum Lexicon Drug Database, with newly prescribed medications excluded. Relevant demographic, socioeconomic, and comorbid factors were included in a multivariate logistic regression model, which accounted for the complex, stratified, multistage survey design of the NAMCS.

RESULTS

There were 390,538 unweighted visit records used in the weighted analysis dataset, corresponding to 9,612,613,668 weighted visits. Statin use was associated with a decreased rate of CRS in both a univariate analysis (odds ratio [OR] = 0.53, P < .001) and the multivariate logistic regression accounting for comorbid, socioeconomic, and demographic factors (OR = 0.79, P = .030).

CONCLUSIONS

Statin use is associated with decreased rates of CRS based on a nationally representative sample of outpatient visits in the United States. This supports research that suggests statin medications may have protective properties against CRS, and further research is warranted into their potential therapeutic value for this indication.

LEVEL OF EVIDENCE

NA Laryngoscope, 130:848-851, 2020.

摘要

目的/假说:他汀类药物长期以来因其降脂特性而被用于心血管疾病的治疗。然而,最近的研究表明,他汀类药物可能通过调节含脂质的酶和介质发挥抗炎作用,因此在治疗慢性鼻-鼻窦炎(CRS)方面可能具有治疗价值。

研究设计

回顾性数据库研究。

方法

查询 2006 年至 2015 年全国门诊医疗调查(NAMCS)数据,分析他汀类药物使用与 CRS 发生率之间的关系。CRS 通过五个诊断变量之一存在疾病分类第 9 版(ICD-9)CRS 代码来表示。他汀类药物的使用通过在 30 种药物变量中存在他汀类药物药物来表示,使用 Multum Lexicon 药物数据库,排除新处方药物。在多变量逻辑回归模型中纳入了相关的人口统计学、社会经济学和合并症因素,该模型考虑了 NAMCS 的复杂、分层、多阶段调查设计。

结果

在加权分析数据集中使用了 390538 个未加权的就诊记录,对应 961261368 个加权就诊。在单变量分析(比值比[OR] = 0.53,P < 0.001)和多变量逻辑回归分析中,他汀类药物的使用与 CRS 发生率降低相关,该回归分析考虑了合并症、社会经济学和人口统计学因素(OR = 0.79,P = 0.030)。

结论

基于美国全国代表性的门诊就诊样本,他汀类药物的使用与 CRS 发生率降低相关。这支持了他汀类药物可能具有预防 CRS 的保护特性的研究,并进一步研究其在该适应症中的潜在治疗价值。

证据水平

NA 喉镜,130:848-851,2020 年。

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