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【商业翻译】他汀类药物与较低的感染风险相关
Newswise — Researchers at Johns Hopkins may have discovered an unintended benefit in the drugs millions of Americans take to lower their cholesterol: The medications, all statins, seem to lower the risk of a potentially lethal blood infection known as sepsis in patients on kidney dialysis. The study is published in the current issue of the Journal of the American Medical Association (JAMA).
Sepsis is the leading cause of death in non-coronary intensive care units in the United States, according to the U.S. Centers for Disease Control. It also poses serious risk for kidney patients undergoing regular dialysis treatments.
The Hopkins researchers cautioned that kidney dialysis patients should not necessarily ask their doctors to put them on statins until more studies are done to verify their findings.
Building on earlier, limited studies that suggested risk reduction in animals and some people, Professor of Medicine, Director of the Welch Center and senior author Neil R. Powe, M.D., and his Johns Hopkins team followed 1041 dialysis patients for 10 years, dividing the subjects into those taking statins and those not.
“Those taking statins had a 41 in a 1,000 chance of being hospitalized for sepsis, while the other group not taking statins had a 110 out of 1,000 risk. Although the overall absolute risk is relatively small, the statin group’s risk is dramatically lower,” says Rajesh Gupta M.D., the study’s lead author, who was a senior medical resident at Hopkins when the study was conducted.
Gupta says it remains unclear why or how statins work this way, “but the consistency of the findings with laboratory studies adds a lot of credence to the idea that statins are doing something substantial to reduce risk.”
“Statins are known to have an effect on the body’s immune system, but what that is exactly, and how many statin users it affects, is still not widely understood.”
Statins may regulate the immune response to infection or fight microbes directly, Powe suspects. The study’s authors also suppose that statins may work like penicillin, since the first statin was originally derived from a fungus which, it is theorized, secretes a statin as a way to starve other competing microorganisms that require cholesterol to survive.
The study included patients from 81 dialysis clinics across 19 states. Only those enrollees who were admitted to the hospital with sepsis were counted, in order to rule out any subjects who became septic during an unrelated hospital stay.
Only 14 percent of those initially enrolled in the study were on statins. Out of the 1,041 patients, there were a total of 303 hospitalizations for sepsis.
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本稿件为《医师报》约稿，署名统一为“丁香”，稿酬按照医师报标准发放。 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 他汀类药物与降低感染风险有关
来自Newswise的报道——美国医学会杂志（JAMA）近期刊文，约翰霍普金斯医学院的研究人员发现了无数美国人用以降低胆固醇的他汀类药物的一个意外益处——即该类药物可降低肾透析患者潜在的罹患脓毒症（一种致命性血源性感染）的风险。
据美国疾控中心统计，脓毒症是美国非冠脉重症监护病房的首位致死原因，也是接受规律透析的肾病患者的严重威胁。
研究者警告，在更多研究验证他们的发现之前，不建议肾病透析患者必需处方他汀类药物。
此前初步的动物及部分人群研究显示，他汀类药物有降低脓毒症风险的作用。基于此发现，韦尔其中心主任、医学教授、论文主要作者Neil R. Powe博士及其麾下的约翰霍普金斯研究团队对使用和未使用他汀类药物的1041例透析患者进行了为期10年的随访。
该研究的第一作者、时任霍普金斯医院高年资住院医的Rajesh Gupta博士说：结果表明，使用他汀类药物组因脓毒症住院的比率为41/1,000，而对照组为110/1,000。尽管总体上绝对风险都相对很小，但他汀组显著低于对照组。他汀类药物发挥该作用的机制仍不清楚。但与之前实验室研究一致的结论，使得他汀类药物确实在降低该类风险中起作用的论断可信度大大增加。
众所周知，他汀类药物可影响机体免疫系统，但其确切作用以及对多少人有作用仍未明了。Powe推测，他汀类药物可能对感染所致的免疫反应有调节作用，或者能够直接对抗微生物。
此外，他汀类药物的作用机制也可能类似于青霉素。因为首个他汀类药物最初源自某种真菌。而理论上，这类真菌可分泌某种他汀类物质以与其他依赖胆固醇存活的微生物竞争。
该研究囊括了来自19个洲、81个透析中心的患者。仅仅那些因脓毒症入院的入选者纳入统计，藉此除外非相关住院期间罹患脓毒症的病例。最初入选的患者中仅有14％使用他汀类药物。1041例患者中，总计有303例因脓毒症入院。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-07-31 17:11
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