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Comprehensive evaluation of effects and safety of statin on the progression of liver cirrhosis: a systematic review and meta-analysis.
BMC Gastroenterology ( IF 2.5 ) Pub Date : 2019-12-30 , DOI: 10.1186/s12876-019-1147-1
Yue Gu 1 , Xueqin Yang 2 , Hang Liang 3 , Deli Li 3
Affiliation  

BACKGROUND Statin has been more and more widely used in chronic liver disease, however, existed studies have attained contradictory results. According to the present study, we aimed to test the efficacy and safety of statin via a meta-analysis. METHODS Different databases were searched for full-text publication based on inclusion and exclusion criteria. For data-pooling, fixed-effect model was applied if heterogeneity wasn't detected. Otherwise, random-effect model was adopted. Heterogeneity was detected by I squire (I2) test. All results of analysis were illustrated as forest plots. Publication bias was assessed using the Begg's adjusted rank correlation test. Standard mean difference (SMD) was calculated in continuous variables. Pooled hazard ratio or odds ratio was calculated in catergorical variables. RESULTS Seventeen clinical studies were finally included. Hepatic portal hemodynamic parameters were improved in statin users for a short-term response. For a long-term follow-up, statin treatment surprisingly decreased mortality rate (HR = 0.782, 95% CI: 0.718-0.846, I2 > 50%) and lower the occurrence of hepatocellular carcinoma (HR = 0.75, 95% CI: 0.64-0.86, I2 > 50%) in liver cirrhosis. Statin seemed not to decrease the risk of esophageal variceal bleeding and spontaneous bacterial peritonitis. However, statin was proved to decrease the risk of hepatic encephalopathy and ascites. Incidence of drug related adverse events didn't increase in statin users. Dose-dependent effects of statin on hepatocellular carcinoma development, decompensated cirrhosis events occurrence, and liver cirrhosis progression. CONCLUSION Statin influenced parameters of hepatic portal vessel pressure in short-term treatment. Prognosis of liver cirrhosis benefited from statin treatment in long term follow-up. The efficacy and safety of statin in liver cirrhosis treatment is confirmed. To date, similar study is hardly seen before.

中文翻译:

他汀对肝硬化进展的影响和安全性的综合评估:系统评价和荟萃分析。

背景技术他汀已在慢性肝病中得到越来越广泛的应用,然而,已有的研究取得了相互矛盾的结果。根据本研究,我们旨在通过荟萃分析测试他汀类药物的疗效和安全性。方法根据纳入和排除标准,在不同的数据库中搜索全文发表。对于数据池,如果未检测到异质性,则应用固定效果模型。否则,采用随机效应模型。通过I squire(I2)测试检测到异质性。所有分析结果均以森林图例说明。使用贝格校正秩相关检验评估出版偏倚。在连续变量中计算标准均值差(SMD)。在分类变量中计算合并的危险比或优势比。结果最终包括十七项临床研究。他汀类药物使用者的肝门血流动力学参数得到了改善,可产生短期反应。对于长期随访,他汀类药物治疗出人意料地降低了死亡率(HR = 0.782,95%CI:0.718-0.846,I2> 50%)并降低了肝细胞癌的发生率(HR = 0.75,95%CI:0.64) -0.86,I2> 50%)。他汀似乎并未降低食管静脉曲张破裂出血和自发性细菌性腹膜炎的风险。然而,他汀被证明可以降低肝性脑病和腹水的风险。他汀类药物使用者中与药物相关的不良事件的发生率并未增加。他汀对肝细胞癌发展,失代偿性肝硬化事件的发生以及肝硬化进展的剂量依赖性作用。结论他汀在短期治疗中影响了肝门血管压力的参数。长期随访他汀类药物治疗可改善肝硬化的预后。他汀类药物在肝硬化治疗中的有效性和安全性得到了证实。迄今为止,以前几乎没有类似的研究。
更新日期:2019-12-30
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