Crit Care Med:他汀类药物与ICU患者谵妄发生之间的关系!

2017-06-17 xing.T MedSci原创

他汀类药物的使用与住院患者谵妄风险降低独立相关。当考虑到使用他汀类药物的类型时,使用阿托伐他汀、普伐他汀和辛伐他汀的患者,这种谵妄风险降低非常显著。对于易患谵妄的住院病人采用各种他汀类药物治疗的随机试验应验证其在预防谵妄中的作用。

近日,危重病医学领域权威杂志Critical Care Medicine上发表了一篇研究文章,该研究旨在探讨他汀类药物的使用与入住ICU患者谵妄风险之间的关系。

从2012年9月1日到2015年9月30日期间,研究人员进行了一项回顾性倾向匹配队列分析。研究人员通过混淆评估方法对10216人次的ICU入住者进行谵妄筛查。此外,6664名参与者被用来匹配他汀类药物使用者和无他汀类使用者。倾向匹配队列的样本中有1475名患者接受他汀类药物治疗并按1:1匹配未使用他汀类药物治疗的对照者。

谵妄定义为混淆评估方法阳性评估结果是主要的终点。在无匹配队列中谵妄的患病率为22.3%,在倾向匹配队列中谵妄的患病率为22.8%。他汀类药物的使用与谵妄的风险显著降低相关(比值比为0.47;95%可信区间为0.38-0.56)。考虑到他汀类药物使用的类型,其中阿托伐他汀(0.51;0.41-0.64)、普伐他汀(0.40;0.28-0.58)以及辛伐他汀(0.33;0.21-0.52)均与谵妄的频率降低显著相关。

他汀类药物的使用与住院患者谵妄风险降低独立相关。当考虑到使用他汀类药物的类型时,使用阿托伐他汀、普伐他汀和辛伐他汀的患者,这种谵妄风险降低非常显著。对于易患谵妄的住院病人采用各种他汀类药物治疗的随机试验应验证其在预防谵妄中的作用。

原始出处:


Mather, Jeffrey F,et al. Statin and Its Association With Delirium in the Medical ICU.critical care medicine. http://journals.lww.com/ccmjournal/Abstract/publishahead/Statin_and_Its_Association_With_Delirium_in_the.96578.aspx

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    2017-06-18 惠映实验室

    他汀类药物临床新作用还是挺多的

    0

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    2017-06-17 海棠胜雪

    学习了

    0

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    2017-06-17 杨利洪

    学习了,提高了

    0

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由此可见,服用他汀类药物的依从性与降低卒中复发风险之间的相关性在房颤患者和非房颤患者中一样强烈,提示房颤状态不应该是一个排除他汀类药物用于患者脑卒中的二级预防的原因。

Intens Care Med:急性呼吸窘迫综合征患者需不需要他汀类药物治疗?

研究人员发现在成年ARDS患者中,无论是整体或预定义的亚组中,开始他汀类药物治疗均没有临床效益。虽然血清肌酸激酶和转氨酶水平升高的发生率增加,但是组间严重不良事件无明显差异。因此,该研究不建议对ARDS患者使用他汀类药物治疗。

Neurology:缺血性卒中出院后他汀类药物依从性的种族差异!

相比于白人成年人,成年黑人在缺血性卒中后更可能出现服用他汀类药物的不依从性。

Lancet:他汀类药物的副作用

阿托伐他汀治疗存在"反安慰剂效应",只有当病人和医生意识到他汀类药物的使用,不是当它的使用被蒙蔽时才会有过量的肌肉相关不良事件的报告。

Clin Gastroenterol H:慢性肝病患者服用他汀类药物与肝硬化及相关并发症的风险分析!

基于系统评价和荟萃分析结果,他汀类药物的使用可能与肝功能失代偿和死亡风险降低相关,并可能会降低CLD患者的门脉高压。需要前瞻性观察性研究和随机对照试验来进一步证实这种观察。

J Hypertens:他汀类药物使用对舒张压水平的有利影响!

由此可见,服用他汀类药物与DBP水平显著降低相关。这些效应可以独立观察到,即使在校正心血管危险因素和合并症,以及降压药物的数量。