October 24, 2006 (盐湖城) -- 研究者在美国胸腔医师学会第72届年会中，发表肺功能衰退的抽烟病患服用降血脂药物statins的话，可以比戒烟而无肺部疾病者减缓衰退情况。
根据奥克拉荷马大学胸腔照护医学组的Walid G. Younis医师所发表之研究发现，该大学医学中心所主导的对抽烟者和戒烟者的研究指出，statins 可以延缓肺功能衰退。
共有485位病患在平均1.6年的研究期间前后各进行一次肺功能检测，将抽烟者和戒烟者分别依照一开始的检测结果分成阻塞性、限制性和正常肺功能，也分别依照有无服用statins治疗
高血脂分组。
这485位病患中有238位服用statins，其中大部分(n = 196)是服用simvastatin，剂量范围是每日20到 80 mg；开始时，整体的一秒内呼气容积(FEV1) 是57% ，最大肺活量 (FVC)是77%。
未服用statins的病患之FEV1 每年降低88 mL，服用statins的病患每年仅降低12 mL (P < .0001)；未服用statins的病患之 FVC每年降低23 mL，服用statins的病患每年上升125 mL (P < .0001)。
Statins 对肺功能的正面效果于抽烟者和非抽烟者相似，与有无阻塞性或限制性疾病无关；Younis医师声称Statin显著降低 35%与呼吸相关问题的急诊和住院比率 (P = .02)。
Younis医师向听众表示，一般人每年约自然损失肺功能约30 mL，Statin药物之使用者的自然减损FEV低，他假设，如果这个研究进行久一点，或许可以看到正常化的肺功能。
Younis医师向Medscape表示，我们未着眼于剂量校正，但是statins已在动物试验证实可预防呼吸道的发炎。
克里夫兰诊所基金会支气管组主任暨肺脏移植医疗召集人Atul C. Mehta医师向Medscape表示，statins在肺脏移植后被常规使用，因为免疫抑制治疗会导致血脂升高。
Mehta医师指出，我们发现statins在移植后延缓肺功能衰退，也降低呼吸道阻塞；我们假设statins降低释出细胞激素且停止发炎反应，而有抗凝血纤维分解效果，就像粥样硬化性心脏病一样， 我们认为可以从一开始就预防疾病病程。
Younis医师报告无相关财金关系。本研究是独立资金。
CHEST 2006: 摘要180S-c. 发表于 October 23, 2006.
Statins Slow Lung Function Decline in Smokers
By Martha Kerr
Medscape Medical News
October 24, 2006 (Salt Lake City) — Lung function decline in smokers taking statins for hypercholesterolemia experience a slower decline in lung function than ex-smokers who have no signs of lung disease, investigators reported here Monday at CHEST 2006, the 72nd annual meeting of the American College of Chest Physicians.
A study of smokers and former smokers conducted at the University of Oklahoma Medical Center in Oklahoma City, shows that statins retard lung function decline to rates that are slower than for the average person, according to Walid G. Younis, MD, from the university's Section for Pulmonary and Critical Care Medicine, who presented the study findings.
A total of 485 patients with a first and last pulmonary function test an average of 1.6 years apart were enrolled. Smokers and ex-smokers were divided into obstructive, restrictive, and normal lung function, according to baseline test results. Smokers and ex-smokers were also divided into those taking statins for the treatment of high cholesterol levels and those who were not.
Of the 485 patients, 238 were taking statins, the majority of whom (n = 196) were receiving simvastatin in doses ranging from 20 to 80 mg daily.
Overall baseline forced expiratory volume in 1 second (FEV1) was 57% of predicted, and baseline forced vital capacity (FVC) was 77% of the predicted value.
FEV1 decreased 88 mL/year in patients not taking statins but decreased by only 12 mL/year in those receiving statins (P < .0001). FVC dropped by 23 mL/year in patients not taking statins and actually increased by 125 mL/year with statin therapy (P < .0001).
The positive effects of statins on lung function were similar in smokers and ex-smokers and occurred regardless of whether their disease was obstructive or restrictive.
Statin use was associated with a significant 35% reduction in emergency department visits and hospital admissions for respiratory-related problems (P = .02), Dr. Younis announced.
"There is a natural loss of lung function in the general population of about 30 mL/year," Dr. Younis told meeting attendees. Statin users had a below-normal loss in FEV1, such that "if the study were longer, we might even see a normalization of lung function," he proposed.
"We didn't look at a dose correlation," Dr. Younis told Medscape, "but statins are known to prevent inflammatory changes in the airways in animal studies."
Atul C. Mehta, MD, medical director of Lung Transplantation and head of the Section of Bronchology at the Cleveland Clinic Foundation in Ohio, told Medscape that statins are routinely used after lung transplantation because of the high lipid levels that result from immunosuppressive therapy.
"We find that statins slow the reduction in lung function after transplantation and decrease airway obstruction," Dr. Mehta said.
"Our hypothesis is that statins decrease the release of cytokines and stop the inflammatory process and they have an antifibrinolytic effect similar to that seen in atherosclerotic heart disease," Dr. Mehta commented. "We think they prevent the disease process from starting."
Dr. Younis reports no relevant financial relationships. The study was independently funded.
CHEST 2006: Abstract 180S-c. Presented October 23, 2006.
作者：
Martha Kerr 2007-6-20