在肝脏的疾病他汀类药物的多效性作用。

StephenW

World J Gastroenterol. 2016 Jul 21;22(27):6201-6213.
Pleiotropic effects of statins in the diseases of the liver.Janicko M1, Drazilova S1, Pella D1, Fedacko J1, Jarcuska P1.
Author information

• 1Martin Janicko, Daniel Pella, Jan Fedacko, Peter Jarcuska, 1 Department of Internal medicine, Pavol Jozef Safarik University in Kosice, Louis Pasteur University hospital, 04001 Kosice, Slovakia.
  

AbstractStatins are a class of molecules that inhibit HMG CoA reductase. They are usually prescribed as a lipid lowering medication. However, there is accumulating evidence that statins have multiple secondary effects both related and unrelated to their lipid-lowering effect. This narrative review of the literature aims to provide the reader with information from clinical studies related to the effect of statin and statins' potential use in patients with liver diseases. In patients with advanced liver disease due to any etiology, statins exhibit an antifibrotic effect possibly through the prevention of hepatic sinusoidal microthrombosis. Two randomized controlled trials confirmed that statins decrease hepatic vein pressure gradient in patients with portal hypertension and improve the survival of patients after variceal bleeding. Lower rates of infections were observed in patients with cirrhosis who received statin treatment. Statins decrease the risk of hepatocellular carcinoma (HCC) in patients with advanced liver disease in general but particularly in patients with chronic hepatitis B and C. Statins in patients with chronic hepatitis C likely increase the virological response to the treatment with pegylated interferon and ribavirin and have the potential to decrease the rate of fibrosis. Finally, data from randomized controlled trials also confirmed that the addition of statin prolongs the survival of patients with advanced HCC even more than sorafenib. Statins are a very promising group of drugs especially in patients with liver disease, where therapeutic options can often be limited. Some indications, such as the prevention of re-bleeding from esophageal varices and the palliative treatment of HCC have been proven through randomized controlled trials, while additional indications still need to be confirmed through prospective studies.


KEYWORDS: Cirrhosis; Esophageal varices; Hepatitis; Hepatocellular carcinoma; Statins

PMID:27468210DOI:10.3748/wjg.v22.i27.6201

StephenW

世界今日医学Gastroenterol。 2016年7月21日; 22（27）：6201-6213。
在肝脏的疾病他汀类药物的多效性作用。
Janicko M1，S1 Drazilova，佩拉D1，Fedacko J1，Jarcuska P1。
作者信息

    1Martin Janicko，丹尼尔·佩拉，扬Fedacko，彼得Jarcuska，内科的1系，科希策帕沃尔约瑟夫沙发利克大学，路易斯·巴斯德大学医院，04001斯洛伐克Kosice。

抽象

他汀类药物是一类抑制HMG CoA还原酶的分子。它们通常规定为降脂药物。然而，有越来越多的证据，他汀类具有两个相关的和无关的其降脂作用多种继发效应。此文献叙述审查的目的是提供从与他汀类药物和他汀类药物的患者的潜在用途与肝脏疾病的效果的临床研究信息的阅读器。中晚期患者的肝脏疾病，由于病因的任何，他汀类药物通过预防肝窦微血栓的可能表现出抗纤维化作用。两项随机对照试验证实他汀类药物降低肝静脉压力梯度在门脉高压患者，提高患者的静脉破裂出血后的生存。肝硬化患者谁收到他汀治疗观察被感染的比率较低。他汀类药物降低但特别是慢性乙型和丙型肝炎他汀类药物在治疗慢性丙型肝炎可能会增加对治疗的病毒学应答与聚乙二醇化干扰素和利巴韦林和患者一般晚期肝病肝细胞癌（HCC）的风险必须减少纤维化的速率的潜力。最后，从随机对照试验的数据也证实，他汀类药物除了延长的患者晚期肝癌索拉非尼相比更加的生存。他汀类药物的药一个非常有前途组尤其是肝病患者，在治疗选择往往是有限的。一些迹象表明，如预防再出血从食管静脉曲张和肝癌的姑息治疗已通过随机对照试验证实，而其它适应症仍需要通过前瞻性研究来确认。
关键词：

肝硬化;食管静脉曲张;肝炎;肝细胞癌;他汀类药物

结论：
    27468210
DOI：
    10.3748 / wjg.v22.i27.6201