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他汀类药物对脑卒中患者 C 反应蛋白的影响:临床试验的系统评价。

The Effect of Statins on C-Reactive Protein in Stroke Patients: A Systematic Review of Clinical Trials.

机构信息

Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Mediators Inflamm. 2021 Aug 27;2021:7104934. doi: 10.1155/2021/7104934. eCollection 2021.

Abstract

BACKGROUND

Statins reportedly have anti-inflammatory effects aside from their lipid-lowering impact. We investigated the effects of statin therapy on the level of C-reactive protein (CRP) or highly sensitive CRP (hs-CRP), a liver-derived marker of systemic inflammation, among stroke patients.

METHODS

An online search was performed in Scopus, PubMed/MEDLINE, ISI Web of Science, and Google Scholar up to November 2020 to recognize clinical trials investigating the effects of statins on the CRP level in stroke patients.

RESULTS

Overall, nine studies (11 treatment arms) with 1659 participants met the inclusion criteria. Six out of 9 studies (8 out of 11 arms) were categorized as studies with a high-quality methodological approach using the Cochrane Collaboration's tool. Data from 5 treatment arms indicated a significant decrease in CRP concentration, and in one treatment arm, CRP concentration did not suggest any considerable alteration following statin therapy. Moreover, two treatment arms showed a significant reduction in hs-CRP concentration and three treatment arms revealed no significant alteration in hs-CRP concentration following statin therapy. Generally, results were heterogeneous and independent of the type of statin, statin dose, treatment duration, and changes in plasma low-density lipoprotein cholesterol concentration.

CONCLUSION

The results suggest that statin therapy could reduce and, therefore, could be considered in these patients as potential anti-inflammatory agents.

摘要

背景

除了降低血脂的作用外,他汀类药物据称还有抗炎作用。我们研究了他汀类药物治疗对中风患者 C 反应蛋白(CRP)或高敏 C 反应蛋白(hs-CRP)水平的影响,CRP 是一种源自肝脏的全身炎症标志物。

方法

在 Scopus、PubMed/MEDLINE、ISI Web of Science 和 Google Scholar 上进行了在线检索,截至 2020 年 11 月,以识别研究他汀类药物对中风患者 CRP 水平影响的临床试验。

结果

共有 9 项研究(11 个治疗组)的 1659 名参与者符合纳入标准。9 项研究中的 6 项(11 个臂中的 8 项)被归类为使用 Cochrane 协作工具具有高质量方法学方法的研究。来自 5 个治疗组的数据表明 CRP 浓度显著降低,而在一个治疗组中,他汀类药物治疗后 CRP 浓度没有明显变化。此外,两个治疗组 hs-CRP 浓度显著降低,三个治疗组 hs-CRP 浓度无明显变化。总体而言,结果存在异质性,与他汀类药物的类型、他汀类药物剂量、治疗持续时间以及血浆低密度脂蛋白胆固醇浓度的变化无关。

结论

结果表明,他汀类药物治疗可能会降低 CRP 水平,因此可以将其视为这些患者的潜在抗炎药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a51/8418548/29b59bf15bd0/MI2021-7104934.001.jpg

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