他汀类药物对稳定期慢性阻塞性肺病治疗效果的Meta分析  

Effects of statins on patients with chronic obstructive pulmonary disease: a Meta analysis

作　　者：吴珍[1] 宋国栋[2] 王伟[1] 

机构地区：[1]山东大学第二医院呼吸内科,山东济南250033 [2]北京协和医学院,北京100730

出　　处：《山东大学学报（医学版）》2015年第2期12-18,共7页Journal of Shandong University:Health Sciences

基　　金：山东省科技攻关计划(2011GSF11813)

摘　　要：目的荟萃分析他汀类药物对稳定期慢性阻塞性肺疾病(COPD)患者肺功能、急性加重情况、炎性因子、临床症状等方面的作用。方法检索自建库至2014年11月Pub Med、Cochrane Library、CNKI、万方以及中文科技期刊数据库发表的随机对照研究(RCTs),评价他汀类药物对稳定期COPD患者的治疗效果。由2名评价员独立筛选检索到的文献,并评价质量、提取数据及交叉核对。使用Rev Man 5.2统计软件处理数据。结果共纳入12项研究,1 589例患者。经他汀类药物治疗后,稳定期COPD患者第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值百分比(FEV1%pred)无明显改善;急性加重情况无显著改善;炎性因子CRP水平降低(WMD为-1.62,95%CI为-1.90^-1.34),TNF-α水平降低(WMD为-5.31,95%CI为-9.45^-1.17),IL-6水平降低(WMD为-0.46,95%CI为-0.89^-0.03);呼吸困难程度及健康相关的生活质量有一定改善。结论他汀类药物可以降低稳定期COPD患者的炎症水平,改善其临床症状,但对肺功能及急性加重情况无明显改善。Objective To evaluate the effects of statins treatment on pulmonary function,exacerbation,inflammatory factors,and health conditions in stable patients with chronic obstructive pulmonary disease （COPD）.Methods Data-bases of PubMed,Cochrane Library,CNKI,Wanfang and VIP were searched up from the day of database construction to November,2014.Randomized controlled trials （RCTs）which investigated the effects of statins treatment on stable COPD patients were identified.Two independent reviewers screened the retrieved literatures,measured the quality,ex-tracted the data and cross-checked them.RevMan 5.2 statistical software was used to analysis the data.Results Twelve RCTs,including 1 589 patients,were included.Statins treatment reduced the levels of blood inflammatory fac-tors,including serum CRP （WMD：-1.62;95%CI：-1.90 to -1.34）,plasma TNF-α（WMD：-5.31;95%CI：-9.45 to -1.17）and serum IL-6 （WMD：-0.46;95%CI：-0.89 to -0.03）,alleviated the clinical symptoms,re-duced the degree of dyspnea,and improved the life quality.Statins treatment could not improve the forced expiratory volume in 1 second （FEV1 ）,FEV1 % predicted （FEV1 %pred）and exacerbation.Conclusion Statins treatment has anti-inflammatory effects and can alleviate clinical symptoms,but has no significant effects on reversing the decline of pulmonary function and preventing exacerbation in stable COPD patients.

关 键 词：肺疾病 慢性阻塞性 稳定期 他汀 META 分析 

分 类 号：R563[医药卫生—呼吸系统]