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标题: 現實生活中接受他汀類藥物治療的不同慢性肝病的肝硬度 [打印本页]

作者: StephenW    时间: 2021-1-5 16:39     标题: 現實生活中接受他汀類藥物治療的不同慢性肝病的肝硬度

Liver stiffness across different chronic liver disease under therapy with statin in a real life cohort

Markova, Antoaneta A.a,,b; Deterding, Katjaa,,b; Port, Kerstina; Bantel, Heikea; Manns, Michael P.a; Cornberg, Markusa; Wedemeyer, Heinera,,bAuthor Information
European Journal of Gastroenterology & Hepatology: February 2021 - Volume 32 - Issue 2 - p 223-229
doi: 10.1097/MEG.0000000000001719

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Abstract
Introduction

Statins have been associated with improved clinical outcomes in patients with viral hepatitis and after variceal bleeding. Still, the clinical benefit of statins is not well defined for different liver diseases. Moreover, associations between statin use and liver stiffness as well as event free survival have not been established.
Methods

Liver stiffness was evaluated in 6490 patients with liver disease (January 2012 till December 2016). Two hundred thirty-four of those received statin therapy, 468 controls without statins were selected by a 1:2 case by case matching using age, sex, underlying liver disease and BMI.
Results

Statins were given to 234 patients with chronic virus hepatitis (n = 104), nonalcoholic fatty liver disease (n = 52), autoimmune liver disease including autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis (n = 31) and hepatitis of unknown origin (n = 47). Follow-up data were available for 96 and 119 pairs (mean follow-up 2 years). Statin users showed reduced inflammatory activity. Elevated liver enzymes were reported in 57% of statin-treated compared with 70% of controls (mean alanine aminotransferase level 53 vs. 74 U/l; P < 0.001). Statin use was well tolerated in this cohort. Mean liver stiffness values were 10.7 kPa (SEM 0.7) and 15.5 kPa (SEM 0.7) accordingly (P < 0.0001). Decompensation was less likely to occur in the statin group, both groups do not defer in the incidence of liver tumor occurrence, transplantation or death (odds ratio = 1, P = nonsignificant).
Conclusions

Use of statins was well tolerated irrespective of liver disease. Statin users showed reduced hepatic inflammatory activity, less severe markers of liver stiffness and portal hypertension. There might be a beneficial effect of statin on the risk to experience hepatic decompensation.

作者: StephenW    时间: 2021-1-5 16:39

現實生活中接受他汀類藥物治療的不同慢性肝病的肝硬度

馬托瓦(Antoaneta A.a,b);威懾,卡賈亞,b; Kerstina港口; Heikea班特爾;曼恩(Michael Man。)馬庫薩,康伯格; Wedemeyer,Heinera,b作者信息
歐洲胃腸病學和肝病學雜誌:2021年2月-第32卷-第2期-第223-229頁
doi:10.1097 / MEG.0000000000001719

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抽象
介紹

在病毒性肝炎和靜脈曲張破裂出血後,他汀類藥物可改善臨床療效。他汀類藥物對於不同肝病的臨床益處仍未明確定義。此外,他汀類藥物的使用與肝臟僵硬以及無事件生存之間的關聯尚未建立。
方法

評價了6490例肝病患者的肝硬度(2012年1月至2016年12月)。在接受他汀類藥物治療的患者中,有234名患者按年齡,性別,基礎肝病和BMI按病例匹配,按1:2病例選擇了468名未使用他汀類藥物的對照組。
結果

234例慢性病毒性肝炎(n = 104),非酒精性脂肪肝疾病(n = 52),包括自身免疫性肝炎,原發性膽源性膽管炎和原發性硬化性膽管炎(n = 31)和自身來源不明的肝炎在內的自身免疫性肝病患者接受了他汀類藥物治療(n = 47)。有96對和119對的隨訪數據(平均隨訪2年)。服用他汀類藥物的人的炎症活動減少。據報導,他汀類藥物治療組有57%的肝酶升高,而對照組則為70%(平均丙氨酸氨基轉移酶水平為53 vs. 74 U / l; P <0.001)。在這個隊列中,他汀類藥物的使用被很好地耐受。相應地,平均肝臟僵硬值為10.7 kPa(SEM 0.7)和15.5 kPa(SEM 0.7)(P <0.0001)。他汀類藥物治療組發生代償失調的可能性較小,兩組均不降低肝腫瘤發生,移植或死亡的發生率(機率= 1,P =無顯著性)。
結論

不管肝臟疾病如何,他汀類藥物的使用都具有良好的耐受性。服用他汀類藥物的人肝臟炎症活動減少,肝硬度和門脈高壓的嚴重指標降低。他汀類藥物對發生肝失代償的風險可能有有益作用。




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