他汀类药物与慢性肝病预后关系的Meta分析  

Meta-analysis of relationship between statins and chronic liver diseases

作　　者：任宁川 胡永强 何平[1] REN Ningchuan;HU Yongqiang;HE Ping(Department of Digestive Medicine,the Fifth Affiliated Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院消化内科

出　　处：《解放军医学院学报》2019年第4期350-356,363,共8页Academic Journal of Chinese PLA Medical School

基　　金：重庆市永川科学技术委员会基金(2016nc5003)~~

摘　　要：目的探讨他汀类药物与慢性肝病预后的关系。方法以"他汀"、"慢性肝病"、"肝硬化"、"statin"、"chronic liver disease"、"cirrhosis"等为检索词,检索PubMed、EMbase、Cochrane、中国生物医学文献、维普、万方、中国知网等数据库,并追溯纳入文献的参考文献,纳入有关他汀类药物治疗慢性肝病的研究,检索时间为自建库至2018年12月,使用Newcastle-OttawaScale(NOS)文献质量评价量表对纳入文献质量进行评价,采用Stata12.0软件进行Meta分析。结果共纳入研究文献12篇,均为英文文献,NOS评分均≥7分。共计375841例患者,其中他汀类药物使用者54584例。Meta分析结果显示:他汀类药物可有效降低肝硬化进展[HR=0.58,95%CI(0.54~0.63),P=0.000]、肝硬化失代偿[HR=0.47,95%CI(0.41~0.53),P=0.000]、肝癌[HR=0.53,95%CI(0.49~0.57),P=0.000]等风险,可能降低慢性肝病患者死亡风险[HR=0.59,95%CI(0.45~0.76),P=0.000]。结论他汀类药物可有效降低慢性肝病患者肝硬化进展、肝硬化失代偿、癌变等风险,可能降低肝硬化患者死亡风险。Objective To explore the association between statins and prognosis of chronic liver diseases.Methods Relevant studies were retrieved from PubMed,EMBASE,Cochrane,China Biomedical Literature,VIP,Wanfang,cnki,and reference literatures of included study were reviewed before December 2018,with search terms including "statin","chronic liver disease","cirrhosis", etc.Newcastle-Ottawa Scale was used to evaluate the quality of the included studies.Meta-analysis was performed using Stata12.0 software.Results A total of 12 research articles involving 375 841 patients were included,of which 54 584 were statin users. All articles were in English,and NOS scores were greater than 7.Meta analysis showed that using statins could decrease the risk of cirrhosis progression (HR,0.58;95% CI,0.54 to 0.63,P =0.000],cirrhosis decompensation (HR,0.47;95% CI,0.41 to 0.53, P =0.000),primary hepatocellular carcinoma (HR,0.53;95% CI,0.49 to 0.57,P =0.000),and probably decrease the risk of death in cirrhosis (HR,0.59;95% CI,0.45 to 0.76,P=0.000).Conclusion Statins can effectively reduce the risk of cirrhosis progression, cirrhosis decompensation,primary hepatocellular carcinoma in patients with chronic liver disease,while maybe reduce the risk of death in cirrhosis.

关 键 词：他汀 慢性肝病 肝硬化 META分析 

分 类 号：R575.2[医药卫生—消化系统]