摘要
本文旨在系统评价他汀类药物对于慢性阻塞性肺病(COPD)患者肺功能的影响。通过计算机检索Medline,EMBASE和The Cochrane Library数据库,检索时限均为从建库至2017年1月,收集COPD患者使用他汀类药物的随机对照试验。采用Stata 12.0软件进行Meta分析。结果共纳入8项研究,534例患者。Meta分析结果显示:他汀类药物没有显著改善FEV1、FEV1/FVC、6分钟步行距离、心率以及C反应蛋白,但活动平板运动时间却有显著提高。亚组分析显示普伐他汀能够显著改善FEV1/FVC。本研究结果提示:他汀类药物没有显著改善COPD患者的肺功能,基于目前的研究结果,不推荐COPD患者常规使用他汀类药物(合并心血管疾病危险因素的患者除外)。
In the current meta-analysis, we aimed to investigate the therapeutic effects of statins on pulmonary function in patients with chronic obstructive pulmonary disease （COPD）. MEDLINE, EMBASE and Cochrane Central Register of clinical trials were systematically searched until January 2017 for RCTs of statins. Only trials with COPD patients were included. The I2 statistic was used to measure heterogeneity between trials and calculated mean differences for pulmonary function parameters with fixed-effect meta-analysis. Eight eligible studies with 534 participants were identified. Statin therapy had no remarkable influence on FEV1 （SMD -0.01, 95% CI -0.204 to 0.184, 12 = 0.0%, P = 0.922, n = 409）, FEV1/FVC （SMD 0.163, 95% CI -0.044 to 0.369, 12 = 0.0%, P = 0.123, n = 364）, 6MWD, heart rate or CRP. However, exercise time on treadmill was remarkably improved by statin therapy （SMD 1.271, 95% CI 0.930 to 1.612, 12 = 0.0%, P = 0.000, n = 160）. Subgroup analysis showed significant, ameliorative effect ofpravastatin on FEV1/FVC （SMD 0.362, 95% CI 0.049 to 0.674, 12 = 0.0%, P = 0.023）. The results of this meta-analysis showed non-significant effect of statins on pulmonary function in COPD patients. Based on the studies reviewed, it is not recommended to prescribe statins for COPD patients without CVD risk factors due to lack of clearly defined benefit.
作者
周祎
王军
张龙
Yi Zhou, Jun Wang, Long Zhang.(Department of Emergency Medicine, Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China)
基金
The Science and Technology Project of Traditional Chinese Medicine of Jiangsu Province(Grant No.YB2015073,Wang J)
