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酒精性肝硬化患者他汀类药物使用情况及他汀类药物起始治疗的预测因素——一项丹麦全国队列研究

Prevalence of Statin Use and Predictors of Statin Initiation Among Patients with Alcohol-Related Cirrhosis - A Danish Nationwide Cohort Study.

作者信息

Ramsing Marine Sølling, Kraglund Frederik, Jepsen Peter

机构信息

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Clin Epidemiol. 2023 Apr 1;15:435-446. doi: 10.2147/CLEP.S401862. eCollection 2023.

Abstract

PURPOSE

Statins reportedly increase the survival of patients with cirrhosis due to alcohol-related liver disease (ALD cirrhosis), but this association might be confounded by socioeconomic status. We examined the prevalence of statin use and socioeconomic and demographic predictors of statin initiation and discontinuation among patients with ALD cirrhosis.

PATIENTS AND METHODS

Using Danish nationwide healthcare registries, we examined statin use among patients diagnosed with ALD cirrhosis in 1997-2018. We computed the prevalence of statin use and incidence of statin initiation and discontinuation, and we used multivariable Cox regression to identify predictors of statin initiation and discontinuation.

RESULTS

We identified 28,260 patients with ALD cirrhosis in 1997-2018. During this period, the prevalence of statin use rose sharply, reaching 19.0% in late 2018. Among patients diagnosed with ALD cirrhosis after 2010, 16.9% were using statins when they were diagnosed with cirrhosis. Among the patients who did not use statins initially, those with lower educational attainment were more likely to begin taking them than those with higher attainment. Also, cohabiting patients were more likely to begin than patients who lived alone, and employed patients were more likely to begin compared to patients outside the labour force. Among current statin users, unemployment predicted statin discontinuation.

CONCLUSION

The use of statins has become increasingly prevalent among Danish patients with ALD cirrhosis, reaching 19.0% in 2018. Employment, cohabitation, and a short education predicted statin initiation after ALD cirrhosis diagnosis, and unemployment predicted statin discontinuation. Overall, statin use was not a marker of a high socioeconomic status.

摘要

目的

据报道,他汀类药物可提高酒精性肝病所致肝硬化(ALD肝硬化)患者的生存率,但这种关联可能会受到社会经济地位的混淆。我们研究了他汀类药物在ALD肝硬化患者中的使用 prevalence 以及开始和停止使用他汀类药物的社会经济和人口统计学预测因素。

患者与方法

利用丹麦全国医疗保健登记系统,我们研究了1997 - 2018年期间被诊断为ALD肝硬化的患者使用他汀类药物的情况。我们计算了他汀类药物的使用 prevalence 以及开始和停止使用他汀类药物的发生率,并使用多变量Cox回归来确定开始和停止使用他汀类药物的预测因素。

结果

我们在1997 - 2018年期间确定了28260例ALD肝硬化患者。在此期间,他汀类药物的使用 prevalence 急剧上升,到2018年末达到19.0%。在2010年后被诊断为ALD肝硬化的患者中,16.9%在被诊断为肝硬化时正在使用他汀类药物。在最初未使用他汀类药物的患者中,受教育程度较低的患者比受教育程度较高的患者更有可能开始服用。此外,同居患者比独居患者更有可能开始服用,就业患者比劳动力之外的患者更有可能开始服用。在目前使用他汀类药物的患者中,失业预示着会停止使用他汀类药物。

结论

他汀类药物在丹麦ALD肝硬化患者中的使用越来越普遍,2018年达到19.0%。就业、同居和低教育水平预示着在ALD肝硬化诊断后会开始使用他汀类药物,而失业预示着会停止使用他汀类药物。总体而言,他汀类药物的使用并非高社会经济地位 的标志。 (注:原文中“prevalence”未准确翻译,可结合语境理解为“流行率、患病率等”,这里保留英文以便准确传达原文意思)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e811/10076903/5d02ebf1387e/CLEP-15-435-g0001.jpg

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