AASLD2020[137]阿司匹林和他汀类药物的联合使用 未治疗的肝细

StephenW

137
ASSOCIATION OF ASPIRIN AND STATIN USE WITH
HEPATOCELLULAR CARCINOMA RISK IN TREATMENT-NAÏVE
NON-CIRRHOTIC PATIENTS WITH CHRONIC HEPATITIS B
Won-Mook Choi1, Hyo Jeong Kim2, Min Jung Ko2 and Young-
Suk Lim1, (1)Department of Gastroenterology, Asan Medical
Center, University of Ulsan College of Medicine, (2)Division
for Healthcare Technology Assessment Research, National
Evidence-Based Healthcare Collaborating Agency
Background: Several observational studies have suggested
that aspirin and statin may prevent hepatocellular carcinoma
(HCC), but have not been fully evaluated, particularly in
treatment-naïve non-cirrhotic patients with chronic hepatitis
B Methods: A nationwide, nested case-control study of
834,825 eligible patients was performed with data from the
National Health Insurance Service between 2005 and 2015
in Korea Patients diagnosed with HCC were matched to
controls based on age, sex, cohort entry year, follow-up
duration, and biennial health examination status Odds ratios
(ORs) and 95% confidence intervals (CIs) for HCC associated
with aspirin and statin use were analyzed by multivariable
conditional logistic regression analyses Separate historical
cohort studies of each drug by Cox proportional-hazards
regression models were conducted to validate the results
Results: Aspirin and statin use were associated with reduced
risk of HCC (adjusted OR, 0 89; 95% CI, 0 85–0 94 and
adjusted OR, 0 39; 95% CI, 0 36–0 40, respectively) The
benefits of statin were dose-dependent; however, those of
aspirin were not dose-dependent In the validation historical
cohorts, aspirin (adjusted hazard ratio (HR), 0 67; 95% CI,
0 63–0 72) and statin (adjusted HR, 0 33; 95% CI, 0 30–
0 37) use were correlated with a decreased HCC risk In
the stratified analyses by each drug use, statin lowered the
incident HCC regardless of aspirin use; however, the HCC
risk reduction of aspirin was not observed, when stratified by
statin use Conclusion: Aspirin and statin were associated
with a reduced risk of HCC in treatment-naïve non-cirrhotic
patients with chronic hepatitis B; however, the benefit of
aspirin may be confounded by statin.

StephenW

137
阿司匹林和他汀类药物的联合使用
未经治疗的非肝硬化的肝细胞癌风险
非慢性乙型肝炎患者
崔元-1，孝贞金2，闵贞子2和Young-
Suk Lim1，（1）牙山医科大学消化内科
蔚山医科大学中心（2）
国家医疗技术评估研究
循证医疗保健合作机构
背景：一些观察性研究表明
阿司匹林和他汀类药物可以预防肝细胞癌
（HCC），但尚未得到充分评估，尤其是在
未经治疗的非肝硬化慢性肝炎患者
B方法：一项全国性，嵌套的病例对照研究
834,825名符合条件的患者接受了来自
2005年至2015年之间的国民健康保险服务
在韩国，被诊断患有HCC的患者与
基于年龄，性别，队列进入年份，随访的对照
时间和两年期健康检查状况的赔率
（OR）和HCC相关的95％置信区间（CI）
阿司匹林和他汀类药物的使用通过多变量分析
条件逻辑回归分析
通过Cox比例风险对每种药物进行的队列研究
进行回归模型以验证结果
结果：阿司匹林和他汀类药物的使用与减少有关
发生HCC的风险（调整后的OR，0 89； 95％CI，0 85-0 94和
调整后的OR 0 39; 95％CI，分别为0 36–0 40）
他汀类药物的益处是剂量依赖性的；但是，
阿司匹林与剂量无关在验证历史中
队列研究人员，阿司匹林（危险比（HR），0 67； 95％CI，
0 63–0 72）和他汀类药物（调整后的HR，0 33； 95％CI，0 30–
0 37）使用与降低的HCC风险相关
每种药物使用情况的分层分析，他汀类药物降低了
不论是否使用阿司匹林，均会发生HCC；但是，HCC
将阿司匹林分层时未观察到降低阿司匹林的风险
他汀类药物的使用结论：阿司匹林和他汀类药物相关
初治非肝硬化患者肝癌风险降低
慢性乙型肝炎患者；但是，
阿司匹林可能与他汀类药物混淆。