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中华危重症医学杂志(电子版) ›› 2016, Vol. 09 ›› Issue (01) : 34 -37. doi: 10.3877/cma.j.issn.1674-6880.2016.01.006

所属专题: 文献

论著

他汀类药物对中国老年脓毒症患者住院期间病死率的影响
归崎峰1, 杨云梅1,(), 张家嘉1   
  1. 1. 310003 杭州,浙江大学医学院附属第一医院老年科
  • 收稿日期:2015-10-18 出版日期:2016-02-01
  • 通信作者: 杨云梅
  • 基金资助:
    浙江省医药卫生一般研究计划(2012KYB084)

Effect of statins on in-hospital mortality in elderly Chinese patients with sepsis: a retrospective cohort study

Qifeng Gui1, Yunmei Yang1,(), Jiajia Zhang1   

  1. 1. Department of Geriatrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
  • Received:2015-10-18 Published:2016-02-01
  • Corresponding author: Yunmei Yang
  • About author:
    Corresponding author: Yang Yunmei, Email:
引用本文:

归崎峰, 杨云梅, 张家嘉. 他汀类药物对中国老年脓毒症患者住院期间病死率的影响[J/OL]. 中华危重症医学杂志(电子版), 2016, 09(01): 34-37.

Qifeng Gui, Yunmei Yang, Jiajia Zhang. Effect of statins on in-hospital mortality in elderly Chinese patients with sepsis: a retrospective cohort study[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(01): 34-37.

目的

探讨他汀类药物对中国老年脓毒症患者住院病死率的影响。

方法

对212例2009年3月至2012年3月在浙江大学医学院附属第一医院老年科住院的老年脓毒症患者进行研究。以出院为观察终点,将患者分为死亡组和存活组。采用多因素Logistic回归模型分析,以确定应用他汀类药物是否为住院期间病死率的的独立影响因素。

结果

存活组使用他汀类药物的患者比例高于死亡组[13.9%(5/36)vs. 34.7%(61/176),χ2 = 6.014,P = 0.014],调整后的比值比(OR)有统计学意义(OR:0.17;95%CI:0.04 ~ 0.85;P = 0.03)。

结论

他汀类药物的使用可能可以降低中国老年脓毒症患者住院期间的病死率。

Objective

To investigate the prognostic value of statins on elderly Chinese patients with sepsis.

Methods

A total of 212 elderly Chinese patients with sepsis hospitalized in First Affiliated Hospital, Zhejiang University School of Medicine, from March 2009 to March 2012 were enrolled into the study. Time to discharge from the hospital was selected as the primary endpoint. All the patients were divided into the death group and survival group, and the variables were compared between the two groups. The multivariate logistic regression was applied to assess the independent risk factors for death among the patients during the hospitalization.

Results

The proportion of the patients treated by statins continuously in the death group was significantly higher than that in the survival group [13.9% (5/36) vs. 34.7% (61/176), χ2 = 6.014, P = 0.014], and the statins were the independent predictor for death during hospitalization (OR: 0.17; 95%CI: 0.04 - 0.85; P = 0.03).

Conclusion

Statins may reduce the in-hospital mortality in elderly Chinese patients with sepsis.

表1 两组脓毒症患者单因素结果的比较
表2 脓毒症患者住院期间病死率多因素Logistic回归分析结果
[1]
Balk RA. Severe sepsis and septic shock. Definitions, epidemiology, and clinical manifestations[J]. Crit Care Clin, 2000, 16 (2): 179-192.
[2]
Hotchkiss RS,Karl IE. The pathophysiology and treatment of sepsis[J]. N Engl J Med, 2003, 348 (2): 138-150.
[3]
Terblanche M,Almog Y,Rosenson RS, et al. Statins and sepsis: multiple modifications at multiple levels[J]. Lancet Infect Dis, 2007, 7 (5): 358-368.
[4]
Jasinska M,Owczarek J,Orszulak-Michalak D. Statins: a new insight into their mechanisms of action and consequent pleiotropic effects[J]. Pharmacol Rep, 2007, 59 (5): 483-499.
[5]
Kouroumichakis I,Papanas N,Proikaki S, et al. Statins in prevention and treatment of severe sepsis and septic shock[J]. Eur J Intern Med, 2011, 22 (2): 125-133.
[6]
Yang KC,Chien JY,Tseng WK, et al. Statins do not improve short-term survival in an oriental population with sepsis[J]. Am J Emerg Med, 2007, 25 (5): 494-501.
[7]
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis[J]. Crit Care Med, 1992, 20 (6): 864-874.
[8]
Mortensen EM,Pugh MJ,Copeland LA, et al. Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia[J]. Eur Respir J, 2008, 31 (3): 611-617.
[9]
Fogerty MD,Efron D,Morandi A, et al. Effect of preinjury statin use on mortality and septic shock in elderly burn patients[J]. J Trauma, 2010, 69 (1): 99-103.
[10]
Calisto KL,Carvalho Bde M,Ropelle ER, et al. Atorvastatin improves survival in septic rats: effect on tissue inflammatory pathway and on insulin signaling[J]. PLoS One, 2010, 5 (12): e14232.
[11]
Merx MW,Liehn EA,Graf J, et al. Statin treatment after onset of sepsis in a murine model improves survival[J]. Circulation, 2005, 112 (1): 117-124.
[12]
Ando H,Takamura T,Ota T, et al. Cerivastatin improves survival of mice with lipopolysaccharide-induced sepsis[J]. J Pharmacol Exp Ther, 2000, 294 (3): 1043-1046.
[13]
Merx MW,Liehn EA,Janssens U, et al. HMG-CoA reductase inhibitor simvastatin profoundly improves survival in a murine model of sepsis[J]. Circulation, 2004, 109 (21): 2560-2565.
[14]
Chaudhry MZ,Wang JH,Blankson S, et al. Statin (cerivastatin) protects mice against sepsis-related death via reduced proinflammatory cytokines and enhanced bacterial clearance[J]. Surgical Infections, 2008, 9 (2): 183-194.
[15]
Subramani J,Kathirvel K,Leo MD, et al. Atorvastatin restores the impaired vascular endothelium-dependent relaxations mediated by nitric oxide and endothelium-derived hyperpolarizing factors but not hypotension in sepsis[J]. J Cardiovasc Pharmacol, 2009, 54 (6): 526-534.
[16]
Boyd AR,Hinojosa CA,Rodriguez PJ, et al. Impact of oral simvastatin therapy on acute lung injury in mice during pneumococcal pneumonia[J]. BMC Microbiol, 2012, 12:73.
[17]
Durant R,Klouche K,Delbosc S, et al. Superoxide anion overproduction in sepsis: effects of vitamin e and simvastatin[J]. Shock, 2004, 22 (1): 34-39.
[18]
Niessner A,Steiner S,Speidl WS, et al. Simvastatin suppresses endotoxin-induced upregulation of toll-like receptors 4 and 2 in vivo[J]. Atherosclerosis, 2006, 189 (2): 408-413.
[19]
Novack V,Eisinger M,Frenkel A, et al. The effects of statin therapy on inflammatory cytokines in patients with bacterial infections: a randomized double-blind placebo controlled clinical trial[J]. Intensive Care Med, 2009, 35 (7): 1255-1260.
[20]
Kruger PS,Harward ML,Jones MA, et al. Continuation of statin therapy in patients with presumed infection: a randomized controlled trial[J]. Am J Respir Crit Care Med, 2011, 183 (6): 774-781.
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