【摘要】 目的系统评价肝硬化门静脉高压患者使用他汀类药物治疗的临床疗效及药物安全性,为临床治疗提供循证参考。方法截至2020年5月,在CNKI、万方、维普、PubMed、Embase和Cochrane Library数据库中搜索他汀类药物治疗肝硬化患者门静脉高压的随机对照研究,主要关注他汀类药物的使用与门脉高压的改善情况和药物安全性的关系,提取符合纳入标准文献中的有效资料,采用Revman 5.3软件进行meta分析。结果最后纳入6项随机对照研究,样本量为368例,其中3篇研究报道了药物不良反应。以测量肝静脉压力梯度(HVPG)减少20%以上或低于12 mmHg作为有效指标,meta分析显示:与对照组相比,他汀类药物能有效降低门静脉压力(RR=1.78,95%CI:1.03～3.08,P=0.04);能显著降低HVPG水平(MD=0.93,95% CI:0.19～1.67,P=0.01);且他汀类药物使用1个月时即能有效降低肝门静脉压力(RR=2.12,95%CI:1.33～3.39,P=0.002),降低HVPG水平(MD=1.59,95%CI:0.54～2.65,P=0.003)。药物安全性方面,两组相比,肌痛的发生率差异无统计学意义(P>0.05)。结论他汀类药物能有效降低肝硬化患者门静脉高压,降低HVPG水平,不良反应少,安全性高。更多还原

【Abstract】 Objective To systematically evaluate the clinical efficacy and drug safety of statins in reducing portal hypertension in patients with cirrhosis and provide evidence-based reference for clinical treatment.Methods We retrieved from CNKI,Wangfang,VIP,PubMed,Embase,and the Cochrane Library database,and included randomized controlled treatment (RCT) using statins in the treatment of liver cirrhosis portal hypertension.Retrieval time was until May 2020,and Revman 5.3 analysis was adopted.The primary concern was the relationship between statin use and portal hypertension improvement and drug safety.Results Six RCTs were included,with a sample size of 368,adverse reactions reported in 3 papers.As an effective indicator,the hepatic venous pressure gradient (HVPG) was measured to reduce>20% of the baseline value or below 12 mmHg.meta analysis results that statins effectively reduced the portal venous pressure compared with that in the control group (RR=1.78,95%CI:1.03-3.08,P=0.04).It significantly reduced HVPG (MD=0.93,95%CI:0.19-1.67,P=0.01).Statin therapy also effectively reduced the hepatic portal venous pressure after 1 month (RR=2.12,95%CI:1.33-3.39,P=0.002),and decreased the gradient level (MD=1.59,95%CI:0.54-2.65,P=0.003).The incidence of myalgia was not significant between the two groups (P>0.05).Conclusion Statins can effectively reduce the portal vein pressure of cirrhosis,with fewer adverse reactions and better safety.更多还原