您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (11): 76-80.doi: 10.6040/j.issn.1671-7554.0.2020.0356

• • 上一篇    下一篇

他汀类药物对70例肺栓塞患者预后的影响

姚宇,王文军,梁玉灵   

  1. 西南医科大学附属医院呼吸与危重症医学二科, 四川 泸州 646000
  • 发布日期:2020-11-04
  • 通讯作者: 王文军. E-mail:438085505@qq.com

Effect of stains on the prognosis of 70 patients with pulmonary embolism

YAO Yu, WANG Wenjun, LIANG Yuling   

  1. Second Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
  • Published:2020-11-04

摘要: 目的 分析他汀类药物对肺栓塞患者预后的影响。 方法 回顾性分析2013年8月1日至2019年8月15日于西南医科大学附属医院住院并首诊为肺栓塞的162例患者的临床资料。根据他汀类药物使用情况分为他汀组(n=70)及非他汀组(n=92)。随访截止时间为2019年9月15日,终点事件为全因死亡。采用Kaplan-Meier法绘制生存曲线及Log-rank检验比较两组生存曲线,将终点事件与使用他汀类药物及基础疾病等行单因素及多因素Cox回归模型分析。 结果 随访期间患者死亡共39例,病死率24.07%;其中,他汀组患者死亡9例,非他汀组患者死亡30例。单因素Cox分析结果表明,对肺栓塞患者预后有意义的指标包括入院年龄、恶性肿瘤、使用他汀类药物、HDL水平、LDL水平、TC水平。在调整年龄、恶性肿瘤、HDL等因素后,多因素Cox回归模型分析显示,使用他汀类药物治疗对肺栓塞患者预后有保护作用(P=0.009, HR=0.348, 95%CI: 0.158~0.766)结论 使用他汀类药物治疗方案可改善肺栓塞患者预后。

关键词: 肺栓塞, 他汀, 预后

Abstract: Objective To investigate the effect of statins on the patients with pulmonary embolism. Methods From Aug. 1st, 2013 to Aug. 15th, 2019, the clinical data of 162 patients with initial diagnosis of pulmonary embolism admitted to the Affiliated Hospital of Southwest Medical University were retrospectively screened. According to the use of statins, the patients were divided into statin group(n=70)and non-statin group(n=92). The deadline of follow-up was Sep. 15th, 2019. The end-event was all-cause death. Kaplan-Meier method was applied to draw the survival curves of two groups which were compared by Log-rank test. Univariate and multivariate Cox proportional hazards regression model were performed to analyze of end-event, use of statins and underline disease, etc. Results During follow-up period, 39 patients(24.07%)died by all-cause, among whom, 9 cases were in statin group and 30 cases were in non-statin group. Univariate Cox proportional hazards regression model analysis showed that age, history of malignancy, use of statins, HDL level, LDL level and TC level influenced the prognosis of patients. After adjustment of age, history of malignancy, HDL level and other factors, multivariate Cox proportional hazards regression model analysis concluded that use of statins had a protective effect on the prognosis of patients with pulmonary embolism(P=0.009, HR=0.348, 95%CI: 0.158-0.766). Conclusion The use of statins can improve prognosis of patients with pulmonary embolism.

Key words: Pulmonary embolism, Statin, Prognosis

中图分类号: 

  • R563.5
[1] 中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组.肺血栓栓塞症诊治与预防指南[J].中华医学杂志, 2018, 98(14): 1060-1087.
[2] Mohammad S, Nguyen H, Nguyen M, et al. Pleiotropic effects of statins: untapped potential for statin pharmacotherapy[J]. Curr Vasc Pharmacol, 2019, 17(3): 239-261.
[3] 段瑞生. 他汀对动脉粥样硬化的免疫调节及其在临床应用中的思考[J]. 山东大学学报(医学版), 2015, 53(5): 1-4. DUAN Ruisheng. Immune-regulation of statins in atherosclerosis and opinions on its clinical applications[J]. Journal of Shandong University(Health Sciences), 2015, 53(5): 1-4.
[4] Skajaa N, Szépligeti SK, Horváth-Puhó E, et al. Initiation of statins and risk of venous thromboembolism: population-based matched cohort study[J]. Thromb Res, 2019, 184: 99-104. doi: 10.1016/j.thromres.2019.11.003.
[5] Miksza JK, Zaccardi F, Kunutsor SK, et al. Statins and risk of thromboembolism: a meta-regression to disentangle the efficacy-to-effectiveness gap using observational and trial evidence[J]. Nutr Metab Cardiovasc Dis, 2019, 29(10): 1023-1029.
[6] Orsi FA, Biedermann JS, Kruip MJHA, et al. Rosuvastatin use reduces thrombin generation potential in patients with venous thromboembolism: a randomized controlled trial[J]. J Thromb Haemost, 2019, 17(2): 319-328.
[7] Kunutsor SK, Seidu S, Khunti K. Statins and primary prevention of venous thromboembolism: a systematic review and meta-analysis[J]. Lancet Haematol, 2017, 4(2): e83-e93. doi: 10.1016/S2352-3026(16)30184-3.
[8] 中华医学会心血管病学分会肺血管病学组,中国医师协会心血管内科医师分会. 急性肺血栓栓塞症诊断治疗中国专家共识[J].中华内科杂志, 2010, 49(1): 74-81.
[9] Turner RM, Yin P, Hanson A, et al. Investigating the prevalence, predictors, and prognosis of suboptimal statin use early after a non-ST elevation acute coronary syndrome[J]. J Clin Lipidol, 2017, 11(1): 204-214.
[10] Stewart LK, Sarmiento EJ, Kline JA. Statin use is associated with reduced risk of recurrence in patients with venous thromboembolism[J]. Am J Med, 2020, 133(8): 930-935.
[11] Yoshikawa Y, Yamashita Y, Morimoto T, et al. Effect of statins on recurrent venous thromboembolism(from the COMMAND VTE registry)[J]. Am J Cardiol, 2020, 125(2): 189-197.
[12] Tagalakis Vi, Eberg M, Kahn S, et al. Use of statins and reduced risk of recurrence of VTE in an older population. A population-based cohort study[J]. Thromb Haemost, 2016, 115(6): 1220-1228.
[13] Kronenberg RM, Beglinger S, Stalder O, et al. Statin therapy and recurrent venous thromboembolism in the elderly: a prospective cohort study[J]. Sci Rep, 2019, 9(1): 14804. doi: 10.1038/s41598-019-51374-8.
[14] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志, 2016, 44(10): 833-853.
[15] Eichinger S, Pecheniuk NM, Hron G, et al. High-density lipoprotein and the risk of recurrent venous thromboembolism[J]. Circulation, 2007, 115(12): 1609-1614.
[16] Olsson AG, Schwartz GG, Szarek M, et al. High-density lipoprotein, but not low-density lipoprotein cholesterol levels influence short-term prognosis after acute coronary syndrome: results from the MIRACL trial[J]. Eur Heart J, 2005, 26(9): 890-896.
[17] Siniscalchi C, Quintavalla R, Rocci A, et al. Statin and all-cause mortality in patients receiving anticoagulant therapy for venous thromboembolism. Data from the RIETE registry[J]. Eur J Intern Med, 2019, 68: 30-35. doi: 10.1016/j.ejim.2019.07.028.
[18] Mohammad S, Nguyen H, Nguyen M, et al. Pleiotropic effects of statins: untapped potential for statin pharmacotherapy[J]. Curr Vasc Pharmacol, 2019, 17(3): 239-261.
[19] Wu K, Tian S, Zhou H, et al. Statins protect human endothelial cells from TNF-induced inflammation via ERK5 activation[J]. Biochem Pharmacol, 2013, 85(12): 1753-1760.
[20] McGuire TR, Kalil AC, Dobesh PP, et al. Anti-inflammatory effects of rosuvastatin in healthy subjects: a prospective longitudinal study[J]. Curr Pharm Des, 2014, 20(7): 1156-1160.
[21] Whitehead NP, Kim MJ, Bible KL, et al. A new therapeutic effect of simvastatin revealed by functional improvement in muscular dystrophy[J]. Proc Natl Acad Sci U S A, 2015, 112(41): 12864-12869.
[22] Nazli Y, Colak N, Alpay MF, et al. Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury[J]. Clinics, 2015, 70(1): 52-60.
[23] Luzak B, Rywaniak J, Stanczyk L, et al. Pravastatin and simvastatin improves acetylsalicylic acid-mediated in vitro blood platelet inhibition[J]. Eur J Clin Invest, 2012, 42(8): 864-872.
[24] Orsi FA, Cannegieter SC, Lijfering WM. Statin therapy to revert hypercoagulability and prevent venous thromboembolism: a narrative review[J]. Semin Thromb Hemost, 2019, 45(8): 825-833.
[25] 代丽, 吴尚洁. 阿托伐他汀抑制RhoA/Rho激酶活性逆转低氧性肺动脉高压大鼠肺动脉高压和肺血管重构[J]. 中南大学学报(医学版), 2011, 36(1): 58-63. DAI Li, WU Shangjie. Atorvastatin attennates hypoxic pulmonary hypertension in rats by inhibiting RhoA/Rho kinase pathway[J]. Journal of Central South University(Medical Science), 2011, 36(1): 58-63.
[1] 徐宁宇 王磊 郝恩魁 苏国海. STEMI患者急诊PCI前口服阿托伐他汀对炎症介质及左心室功能的影响[J]. 山东大学学报(医学版), 2209, 47(6): 69-72.
[2] 高秀蕊 臧恒昌. 复方烟酸辛伐他汀双层片体外释放度的研究[J]. 山东大学学报(医学版), 2209, 47(6): 109-113.
[3] 栗英林,宋道庆,徐忠华. 应用生物信息学方法分析肾透明细胞癌中FKBP11的表达[J]. 山东大学学报 (医学版), 2020, 1(9): 45-51.
[4] 路璐,孙志钢,张楠. 继发性嗜血细胞综合征1例[J]. 山东大学学报 (医学版), 2020, 1(7): 122-124.
[5] 史爽,李娟,米琦,王允山,杜鲁涛,王传新. 胃癌miRNAs预后风险评分模型的构建与应用[J]. 山东大学学报 (医学版), 2020, 1(7): 47-52.
[6] 李星凯,刘战业,姜运峰,李军. 原发性中央型和周围型肺鳞癌临床病理学及预后差异[J]. 山东大学学报(医学版), 2017, 55(9): 73-78.
[7] 宗帅,肖东杰,刘华,郏雁飞,马晓丽,李焕杰,黎娉,郑燕,汪运山. CSN5在胃癌中的表达及与患者预后的相关性[J]. 山东大学学报(医学版), 2017, 55(7): 12-16.
[8] 宋昱,毛洋,刘庆梅,乔磊,帖媛媛,鲁璐,张蕾. 通心络对兔腹主动脉粥样硬化易损斑块中三维应变的影响[J]. 山东大学学报(医学版), 2017, 55(5): 1-7.
[9] 高建步,杨守忠,李玉东,乔崇,张松雨. 南阳地区某医院急性心肌梗死患者院内用药10年变化趋势[J]. 山东大学学报(医学版), 2017, 55(5): 66-69.
[10] 孙启晶,陈方方,李春晓,张才擎. PNI及HGB评估中晚期非小细胞肺癌患者预后的临床价值[J]. 山东大学学报(医学版), 2017, 55(4): 55-59.
[11] 董尧,宋亚林,田涛,高建国. 确诊8年未经治疗却无明显进展的阴茎恶性黑色素瘤1例报道[J]. 山东大学学报(医学版), 2017, 55(3): 125-126.
[12] 林家香,郭子嘉,苏鹏,王晓,郭雅欣,吴晓娟,相磊,周志强, 王妍,崔秀杰,潘爱凤,郭成浩. 致癌蛋白CIP2A在乳腺导管上皮恶变中的作用及预测浸润性导管癌患者预后的能力[J]. 山东大学学报(医学版), 2017, 55(3): 100-106.
[13] 周兰兰,潘学谊,郭煜. 48例急性混合细胞表型白血病患者的临床特征及预后[J]. 山东大学学报(医学版), 2017, 55(2): 79-83.
[14] 张希英,翟春颜,李劲松,韩博. 中国尤文肉瘤患者EZH2蛋白表达与临床病理学参数及预后的关系[J]. 山东大学学报(医学版), 2017, 55(2): 84-91.
[15] 刘惠苓,王兴文,冯少滨,冯虹,韩俊庆. B类I型清道夫受体的高表达与结肠癌患者预后的相关性[J]. 山东大学学报(医学版), 2017, 55(10): 84-89.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!