他汀类药物在治疗肝病中的潜在作用

StephenW

The potential role of statins in treating liver disease
Konstantinos P. Imprialos ORCID Icon, Konstantinos Stavropoulos, Michael Doumas, Anastasia Skalkou, Ioanna Zografou & Vasilios G. Athyros
Pages 331-339 | Received 24 Nov 2017, Accepted 07 Feb 2018, Accepted author version posted online: 12 Feb 2018, Published online: 12 Feb 2018

    Download citation https://doi.org/10.1080/17474124.2018.1439379



ABSTRACT

Introduction: Statins are commonly use for the management of dyslipidemia, worldwide. Various studies have demonstrated that statins offer significant reduction in the risk of cardiovascular morbidity and mortality. However, this class of drugs has been implicated in potential liver toxicity, thus has been considered as a ‘forbidden-drug’ in patients with increased liver enzymes.

Areas covered: Studies have shown that statins might offer clinical benefits in the setting of viral hepatitis, progression of cirrhosis, and hepatocellular carcinoma. More importantly, this class of drugs was shown to ameliorate liver histological (in both imaging and biopsy studies) and functional alterations in patients with non-alcoholic fatty liver disease or non-alcoholic steatohepatitis. In addition, two large survival studies have demonstrated reduction in the risk for cardiovascular events with statin use in patients with elevated transaminase levels at baseline.

Expert commentary: These benefits were of greater extent compared with patients with normal liver function tests at baseline. However, current international guidelines seem to neglect these findings and are not including statins in the management algorithm of patients with non-alcoholic fatty liver disease or steatohepatitis. Future randomized studies providing biopsy-proven benefits will establish the use of statins in the prevention of cardiovascular events and therapeutic algorithm of these patients.
KEYWORDS: Statins, liver diseases, non-alcoholic fatty liver disease, hepatocellular cancer, liver cirrhosis, cardiovascular risk

StephenW

他汀类药物在治疗肝病中的潜在作用
Konstantinos P. Imprialos ORCID Icon，Konstantinos Stavropoulos，Michael Doumas，Anastasia Skalkou，Ioanna Zografou＆Vasilios G. Athyros
第331-339页|收到2017年11月24日，接受2018年2月7日，接受作者版本在线发布：2018年2月12日，在线发布：2018年2月12日

    下载引文https://doi.org/10.1080/17474124.2018.1439379



抽象

简介：他汀类药物通常用于控制全球范围内的血脂异常。各种研究表明，他汀类药物可显着降低心血管发病率和死亡率。然而，这类药物与潜在的肝毒性有关，因此被认为是肝酶增加患者的“禁用药物”。

涵盖的领域：研究表明，他汀类药物可能为病毒性肝炎，肝硬化进展和肝细胞癌提供临床益处。更重要的是，这类药物可改善非酒精性脂肪性肝病或非酒精性脂肪性肝炎患者的肝组织学（在影像学和活检研究中）和功能改变。此外，两项大型存活研究显示，基线时转氨酶水平升高的患者使用他汀治疗心血管事件的风险降低。

专家评论：与基线时具有正常肝功能测试的患者相比，这些益处的程度更大。然而，目前的国际指南似乎忽视了这些发现，并且在非酒精性脂肪性肝病或脂肪性肝炎患者的管理算法中未包括他汀类药物。未来随机研究提供活检证实的益处将建立使用他汀类药物预防心血管事件和这些患者的治疗算法。
关键词：他汀类药物，肝脏疾病，非酒精性脂肪肝疾病，肝细胞癌，肝硬化，心血管风险

9病成医