In the recent years, there have been an increasing number of reports on favourable effects of statins in patients with advanced chronic liver disease. These include reduction in portal pressure, improved liver sinusoidal endothelial and hepatic microvascular dysfunction, decreased fibrogenesis, protection against ischaemia/reperfusion injury, safe prolongation of ex vivo liver graft preservation, reduced sensitivity to endotoxin-mediated liver damage, protection from acute-on-chronic liver failure, prevention of liver injury following hypovolaemic shock and preventing/delaying progression of cirrhosis of any aetiology. Moreover, statins have been shown to have potential beneficial effects in the progression of other liver diseases, such as chronic sclerosing cholangitis and in preventing hepatocellular carcinoma. Because of these many theoretically favourable effects, statins have evolved from being considered a risk to kind of wonder drugs for patients with chronic liver diseases. The present article reviews the current knowledge on the potential applications of statins in chronic liver diseases, from its mechanistic background to objective evidence from clinical studies.

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肝硬化作为他汀类药物的新适应症

近年来，关于他汀类药物对晚期慢性肝病患者的有益作用的报道越来越多。这些包括降低门静脉压力、改善肝窦内皮和肝微血管功能障碍、减少纤维化、防止缺血/再灌注损伤、安全延长离体肝移植保存、降低对内毒素介导的肝损伤的敏感性、防止急性-慢性肝功能衰竭，预防低血容量性休克后的肝损伤和预防/延迟任何病因的肝硬化进展。此外，他汀类药物已被证明在其他肝脏疾病的进展中具有潜在的有益作用，例如慢性硬化性胆管炎和预防肝细胞癌。由于这些许多理论上有利的作用，他汀类药物已从被认为是慢性肝病患者的一种风险药物演变为一种神奇的药物。本文回顾了目前关于他汀类药物在慢性肝病中的潜在应用的知识，从其机制背景到临床研究的客观证据。