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Clin Gastroenterol H:他汀类药物与原发性硬化性胆管炎患者结局改善相关

2018-11-16 xing.T MedSci原创

由此可见,在瑞典患有PSC的基于人群的患者队列中,研究人员将他汀类药物和硫唑嘌呤的使用与死亡以及死亡或肝移植风险降低联系在一起。接触熊去氧胆酸与死亡率降低无关。

越来越多的证据表明他汀类药物可以使患有慢性肝病的患者受益,但是他们的影响尚未在原发性硬化性胆管炎(PSC)患者中进行过研究。近日,消化病领域权威杂志《Clinical Gastroenterology and Hepatology》发表了一篇研究文章,研究人员在瑞典进行了一项全国性研究,以确定接触药物(包括他汀类药物)对PSC患者的影响。

研究人员分析了一项基于人群的瑞典患者队列,其中包含了2005年至2014年期间PSC和伴随溃疡性结肠炎克罗恩病的患者(n=2914),随访至2016年。研究人员收集了的数据来自患者登记中心,处方药物登记处、死亡证明登记中心和癌症登记中心。研究人员计算了与药物暴露相关的风险或死亡、肝移植、食管静脉曲张出血和癌症。

PSC诊断时患者的平均年龄为41.4岁(四分位数间[IQR]为25.6-56.1岁)。总随访时间为11769人次每年,其中3.4%的患者接受肝移植,19.9%的患者死亡。暴露于药物的患者比例为:熊去氧胆酸为60.2%; 5-氨基水杨酸为74.4%;硫唑嘌呤或巯基嘌呤为33.7%以及他汀类药物为13.9%。使用他汀类药物可降低全因死亡(风险比[HR]为0.68; 95%CI为0.54-0.88)以及死亡或肝移植风险(HR为0.50; 95%CI为0.28-0.66)。使用硫唑嘌呤也与降低死亡(HR为0.66; 95%CI为0.52-0.84)以及死亡或肝移植风险(HR为0.65; 95%CI为0.50-0.83)有关。接触熊去氧胆酸并不影响死亡率(HR为1.04; 95%CI为0.87-1.25)。

由此可见,在瑞典患有PSC的基于人群的患者队列中,研究人员将他汀类药物和硫唑嘌呤的使用与死亡以及死亡或肝移植风险降低联系在一起。服用熊去氧胆酸与死亡率降低无关。
 
原始出处:
 
Knut Stokkeland,et al.Statin Use is Associated with Improved Outcomes of Patients With Primary Sclerosing Cholangitis. clinical gastroenterology and hepatology 2018. https://www.cghjournal.org/article/S1542-3565(18)31245-X/fulltext

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    2019-02-07 许安
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    2018-11-16 医者仁心5538

    学习了

    0

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由此可见,缺乏令人信服的证据表明他汀类药物与非CVD结局之间存在关联,这使得保持目前的建议不变。

Prostate Cancer P D:他汀类药物能够减少经历雄激素阻断治疗糖尿病患者的痴呆风险

雄激素阻断治疗(ADT)已经被报道可以增加痴呆的风险,而他汀类药物的使用可以减少痴呆的风险。最近,有研究人员在接受ADT的2型糖尿病(T2DM)患者中,调查了他汀类药物的使用和痴呆之间的相关性。研究总共包括了在1998年到2013年之间新诊断为PCa的9855名T2DM患者,其中5427名患者因PCa接受了雄激素阻断治疗。在倾向性评分匹配之后,1006名他汀类药物使用者和1006名非他汀类药物使用

J Neurol Neurosur Ps:他汀类药物与脑卒中患者脑出血风险的关系

由此可见,无论卒中亚型如何,他汀类药物治疗对未来ICH均无明显趋势。然而,这种风险因他汀类药物使用者死亡率和功能结局的显著改善而被掩盖。

Brit J Cancer:他汀类药物的使用与对侧乳腺癌的风险

由此可见,研究人员发现他汀类药物可降低CBC风险。需要进一步评估以解开长期服用所产生的模棱两可的结果,并确定ER阴性乳腺癌患者是否可以从服用他汀类药物中获益最多。

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