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B. Pertzov N. Eliakim-Raz H. Atamna A.Z. Trestioreanu D. Yahav L. Leibovici 《Clinical microbiology and infection》2019,25(3):280-289
Objectives
The pleiotropic effect of hydroxymethylglutaryl-CoA reductase inhibitors (statins) might have a beneficial effect in sepsis through several mechanisms. The aim was to assess the efficacy and safety of statins, compared with placebo, for the treatment of sepsis in adults.Methods
We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2017, Issue 12), OVID MEDLINE (from 1966 to January 2018), Embase (Ovid SP, from 1974 to January 2018), and LILACS (from 1986 to January 2018). We also searched the trial registries ISRCTN and ClinicalTrials.gov to January 2018. The eligibility criteria were randomized controlled trials comparing the treatment of statins versus placebo in adult patients who were hospitalized due to sepsis. Participants were adults (16 years and older) hospitalized because of sepsis or who developed sepsis during admission. Interventions were treatment with hydroxymethylglutaryl-CoA reductase inhibitors (statins) versus no treatment or placebo. We performed a systematic review of all randomized controlled trials published until January 2018, assessing the efficacy and safety of statins in sepsis treatment. Two primary outcomes were assessed: 30-day overall mortality and deterioration to severe sepsis during management. Secondary outcomes were hospital mortality, need for mechanical ventilation and drug related adverse events.Results
Fourteen trials evaluating 2628 patients were included. Statins did not reduce 30-day all-cause mortality neither in all patients (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.83–1.10), nor in a subgroup of patients with severe sepsis (RR 0.97, 95% CI 0.84–1.12). The certainty of evidence for both outcomes was high. There was no change in the rate of adverse events between study arms (RR 1.24, 95% CI 0.94 to 1.63). The certainty of evidence for this outcome was high.Conclusions
The use of statin therapy in adults for the indication of sepsis is not recommended. 相似文献2.
目的研究硝酸酯类和他汀类等一氧化氮（NO）供体的抗柯萨奇病毒B组3型（CVB3）的作用及其特点和机制。方法用TCID50和空斑形成实验测定CVB3的毒力；MTT法确定NO供体药物的无毒性浓度；利用细胞病变效应（CPE）抑制实验和空斑形成抑制实验分析NO供体药物对CVB3在HeLa细胞和ECV．304细胞中增殖的抑制作用；并分析硝酸甘油（GRIN）不同给药次数、NO浓度变化以及NO浓度与GTN对CVB3抑制效应间的相关性。结果硝酸酯类药物GTN、硝酸异山梨酯可明显抑制CVB3所致的CPE及空斑形成（P〈0．05），他汀类药辛伐他汀、洛伐他汀均未显示抑制CVB3所致的CPE（P〉0．05）；CVB3接种前预先与GTN作用、CVB3接种同时加入GTN两种条件下CPE抑制率差异无统计学意义（P〉0．05）；CVB3攻击后多次给予GTN的组间CPE抑制率差异无统计学意义（P〉0．05），但在CVB3攻击前不同时间点给予GTN的组间CPE抑制率差异有统计学意义（P〈0．05）；NO浓度与不同时间点给予GrIN的CPE抑制结果呈正相关（r=0．97，P〈0．01）。结论NO供体类药物硝酸酯类具有明确的抗CVB3感染作用，其抗CVB3增殖的作用与NO浓度呈正相关；他汀类药物在本实验条件下未观察到抗CVB3增殖作用，原因可能是细胞类型与他汀不匹配。 相似文献
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《Journal of clinical lipidology》2020,14(5):707-719
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本文论述了强化他汀与联合调脂在降脂效应、临床获益和安全性之间的差别,指出强化他汀不同于联合调脂;其次强调强化他汀在概念上不同于强化降脂,临床实践中强化他汀的提法更为适合。 相似文献
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