他汀类药物治疗可能降低胰腺炎风险
2012-08-24 17:54:06   来源： 丁香园   作者：  评论：0 点击：

1. According to results of an analysis published in JAMA, stain therapy is connected with a lower risk of pancreatitis in patients with normal or mildly elevated triglyceride levels.

根据一项发表在JAMA杂志上的分析结果，对甘油三酯正常或轻度升高的患者，他汀类药物治疗与降低胰腺炎风险相关。

2. The researchers explained:

研究者的解释为：

3. "Pancreatitis has a clinical spectrum ranging from a mild, self-limiting episode to a severe or fatal event. Case reports and pharmacoepidemiology studies have claimed that statins may cause pancreatitis, although few of these studies comprehensively considered confounding factors. Very few large randomized trials of statin therapy have published data on incident pancreatitis. Although lipid guidelines recommend fibrate therapy to reduce pancreatitis risk in person with hypertriglyceridemia, fibrates may lead to the development of gallstones, a risk factor for pancreatitis."

“胰腺炎有广泛的临床表现，从轻度、自限性 发作到严重或致死性事件。病例报导和药物流行病学研究已显示，他汀类药物可能引起胰腺炎，但这些研究中很少综合考虑各种混淆因素（的影响）。极少有大型的 他汀类药物治疗的随机研究发表胰腺炎的发生。尽管在血脂治疗指南中，在高甘油三酯血症（的患者）中推荐贝特类药物治疗已降低胰腺炎风险，贝特类药物可能导 致胆结石，也是胰腺炎发生的一个危险因素。

4. In order to examine the associations between the use of a statin or a fibrate and the incidence of pancreatitis, David Preiss, M.D., Ph.D., of the University of Glasgow, United Kingdom, and colleagues conducted a collaborative meta-analyses of published and unpublished data from large randomized clinical trials.

为了检验使用他汀类或贝特类药物与胰腺炎发生率之间的关系，英国格拉斯哥大学的David Preiss, M.D., Ph.D.及其同事，开展了一项合作的meta分析，分析大型临床随机对照研究中发表及未发表的数据。

5. In 16 placebo- and standard care-controlled statin trials involving 113,800 participants, the team found that individuals assigned to statin therapy were 23% less likely to develop pancreatitis than those assigned to the control group. In five dose-comparison, statin trials involving 39,614 participants that team found that 156 developed pancreatitis: 70 assigned to intensive dose and 86 assigned to moderate dose; an 18% lower risk for the intensive dose group.

在16项安慰剂及标准治 疗对照的他汀类药物研究中，包括了113,800名受试者，研究小组发现分配给他汀类药物的个体与对照组相比，胰腺炎发生率似乎低了23%。在5项剂量比 较的他汀类药物研究中，包括了39,614名受试者，研究小组发现156人发生了胰腺炎：70人为强化剂量，86人为中等剂量；强化剂量组风险降低 18%。

6. In the combined data set of 21 trials, the team found that 465 participants developed pancreatitis. Those assigned to statin therapy were 21% less likely to develop pancreatitis than those assigned to placebo.

在21项研究的合并数据集中，研究小组发现465名受试者发生了胰腺炎。他汀类药物治疗组的受试者与使用安慰剂组相比，胰腺炎发生率似乎降低21%。

7. In addition, results from 7 randomized clinical trials of fibrate therapy involving 40,162 participants showed that 144 participants (0.36%) developed pancreatitis (84 assigned to fibrate therapy, 60 assigned to placebo), but the risk difference was not statistically significant. Baseline average triglyceride levels in the trials varied from 145 mg/dL to 184 mg/dL.

并且7项贝特类药物的随机对照临床研究，包括40,162受试者的结果显 示，144名受试者(0.36%)发生了胰腺炎 (84名在贝特类药物组, 60名在安慰剂组), 但两组风险差异无统计学意义。研究中基线平均甘油三酯水平为145 mg/dL 至184 mg/dL。

8. The researchers said:

研究者阐明：

9. "Although the present results for both statins and fibrates should be considered hypothesis-generating and the number of pancreatitis cases was small in this trial population at low risk of pancreatitis, the analysis raises questions regarding the choice of lipid-modifying agents in patients with hypertriglyceridemia. In those with slightly elevated triglyceride levels, statins appear better supported by the available data than fibrates for preventing pancreatitis. Lifestyle modifications also remain important to improve lipid profiles in such individuals. In patients with severe hypertriglyceridemia, a trial comparing fibrates and statins for preventing pancreatitis would be clinically valuable."

“尽 管现有结果中应被视为他汀类药物和贝特类药物的“假设产生性”，且胰腺炎低风险人群中发生胰腺炎的病例数少，此分析仍提出了在高甘油三酯血症的患者中，调 脂药物的选择问题。在甘油三酯轻度升高的人群中，现有数据支持他汀类药物相对于贝特类药物可更好预防胰腺炎。在此类人群中，生活方式的改变对血脂谱的改善 仍然有重要意义。对于重度高甘油三酯血症的患者，一项比较贝特类与他汀类药物在预防胰腺炎方面作用的研究将会非常有临床价值。”