由于关于他汀类药物治疗PAH的证据还没有定论,我们通过对现有研究的系统评价和荟萃分析,评估了他汀类药物治疗对PAH的影响.我们检索了截至2015年8月1日的选定数据库,以确定调查他汀类药物对PAH影响的研究。根据I(2)统计量,使用固定效应或随机效应模型进行荟萃分析。对8项研究对665例患者进行的荟萃分析显示,他汀类药物治疗对6分钟步行距离(6MWD)没有显着改善(加权平均差[WMD]:-6.08m,95%置信区间[CI]:-25.66,13.50,p=0.543;Q=8.41,I(2)=28.64%)。同样,其他指标均不包括肺动脉压(WMD:-0.97mmHg,95CI:-4.39,2.44,p=0.577;Q=14.64,I(2)=79.51%),右心房压(WMD:1.01mmHg,95CI:-0.93,2.96,p=0.307;Q=44.88,I(2)=95.54%),心脏指数(WMD:0.05L/min/m(2),95CI:-0.05,0.15,p=0.323;Q=3.82,I(2)=21.42%),和肺血管阻力(WMD:-1.42dyn*s/cm(5),95CI:-72.11,69.27,p=0.969;Q=0.69,I(2)=0%)被他汀类药物治疗显著改变。总之,荟萃分析的结果显示他汀类药物治疗对6MWD的改善没有统计学意义,肺动脉压,右心房压力,心脏指数和肺血管阻力。
Since the evidence regarding statin therapy in PAH has not been conclusive, we assessed the impact of statin therapy in PAH through a systematic
review and meta-analysis of available studies. We searched selected databases up to August 1, 2015 to identify the studies investigating the effect of statin administration on PAH. Meta-analysis was performed using either a fixed-effects or random-effect model according to I(2) statistic. Meta-analysis of 8 studies with 665 patients did not suggest any significant improvement in 6-min walking distance (6MWD) by statin therapy (weighed mean difference [WMD]: -6.08 m, 95% confidence interval [CI]: -25.66, 13.50, p = 0.543; Q = 8.41, I(2) = 28.64%). Likewise, none of the other indices including pulmonary arterial pressure (WMD: -0.97 mmHg, 95%CI: -4.39, 2.44, p = 0.577; Q = 14.64, I(2) = 79.51%), right atrial pressure (WMD: 1.01 mmHg, 95%CI: -0.93, 2.96, p = 0.307; Q = 44.88, I(2) = 95.54%), cardiac index (WMD: 0.05 L/min/m(2), 95%CI: -0.05, 0.15, p = 0.323; Q = 3.82, I(2) = 21.42%), and pulmonary vascular resistance (WMD: -1.42 dyn*s/cm(5), 95%CI: -72.11, 69.27, p = 0.969; Q = 0.69, I(2) = 0%) was significantly altered by statin therapy. In conclusion, the results of the meta-analysis did not show a statistically significant effect of statin therapy in the improvement of 6MWD, pulmonary arterial pressure, right atrial pressure, cardiac index and pulmonary vascular resistance.