长期使用不同他汀类药物治疗COPD患者的meta分析

目的 系统评价他汀类药物治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）时的炎症反应和肺功能状况。方法 检索PubMed、Web of Science、Elsevier和中国知网数据库，收集使用他汀类药物治疗COPD患者>3个月的研究。结果 meta分析结果显示，长期使用他汀类药物治疗的COPD患者可以降低C反应蛋白（C-reactive protein，CRP）和白细胞介素6（Interleukin-6，IL-6）等炎症因子水平，其SMD （95% CI）分别为-1.04（-1.38，-0.71）和-0.70（-1.04，-0.36）；亚组分析显示，阿托伐他汀降低CRP和IL-6效果更明显，其SMD （95% CI）分别为-1.61（-2.35，-0.86）和-0.98（-1.29，-0.66）。长期使用他汀类药物治疗的COPD患者可增强用力呼气容积占预计值百分比（lung function index of forced expiratoryvolume in one second percent，FEV1%）和第1秒用力呼气容积/用力肺活量百分比（forced expiratory volume in onesecond/forced vital capacity，FEV1/FVC%）等肺功能指标，其SMD （95% CI）分别为0.52（0.19，0.86）和0.41（0.16，0.70）；阿托伐他汀增加FEV1%、FEV1/FVC%等肺功能指标的效果更明显，其SMD （95% CI）分别为0.82（0.55，1.08）和0.82（0.46，1.18）。结论 长期使用他汀类药物治疗的COPD患者能有效降低炎症反应、增强肺功能；阿托伐他汀治疗COPD患者的临床效果更佳。

Meta-analysis of Long-term using Different Statins in Patients with COPD

OBJECTIVE To systematically evaluate inflammatory responses and pulmonary function in patients with chronic obstructive pulmonary disease(COPD) using different statins. METHODS Collecting studies of COPD patients using statins for more than three months by searching PubMed, Web of Science, Elsevier and CNKI database. RESULTS The results of meta-analysis showed that long-term using statins reduced the levels of inflammatory factors including C-reactive protein(CRP), interleukin-6(IL-6), etc, the SMD(95%CI) were -1.04(-1.38, -0.71) and -0.70(-1.04, -0.36), respectively. Subgroup analysis showed that atorvastatin was more effective in reducing CRP and IL-6, the SMD(95%CI) were -1.61(-2.35, -0.86) and -0.98(-1.29, -0.66), respectively. Long-term using statins increased pulmonary function including lung function index of forced expiratory volume in one second percent(FEV1%) and forced expiratory volume in one second/forced vital capacity(FEV1/FVC%), the SMD(95%CI) were 0.52(0.19, 0.86) and 0.41(0.16, 0.70), respectively. Atorvastatin was more effective in increasing lung function indicators including FEV1% and FEV1/FVC%, the SMD(95%CI) were 0.82(0.55, 1.08) and 0.82(0.46, 1.18), respectively. CONCLUSION Long-term using statins can effectively reduced the inflammatory response and enhanced lung function in COPD patients. The clinical effect of atorvastatin in patients with COPD is better.