降脂药可保护吸烟者的肺

2006-11-03 00:00 来源:丁香园 作者:cplamst 译
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一个研究小组今天报道,用于降脂的他汀类药物能防止吸烟者因吸烟导致的肺部损害。他们对现在或以前吸烟者的研究显示,服用他汀类药物的患者因相关肺部疾病而需要住院或者急诊的几率比不服用该类药物的患者低35%。

他汀类药物是一类以降胆固醇和防止心脏病发生著称的畅销药。然而在过去10年里,科学家已经认识到这类药物似乎也能减轻炎症反应——动物实验提示他汀类药物可以保护肺脏。

美国俄克拉荷马洲立大学医学中心的Walid Younis及其同事查看了485名现在或以前吸烟者的医疗记录。他们比较了平均2.7年前,这些患者所做的肺部健康检查情况。服用他汀类药物的患者,肺部状况更好。例如,肺容量在他汀药物组患者每年降低1%,而对照组患者每年降低10%。“这给我们留下深刻印象,”Younis说。他在美国犹他州盐湖城举行的美国胸内科医师学会会议上报告了这项研究结果。

现在需要设计更加严密的随机临床试验对这种关联进行评估。如果这种关联成立,那说明吸烟者可以用他汀类药物(目前被认为是安全的)来减轻吸烟造成的肺损伤。目前还没有其他药物能用于保护吸烟相关的肺损伤。

专家特别强调,服用他汀类药物绝比不上戒烟的受益。美国北卡罗来纳州三角研究园国立环境卫生科学研究所呼吸生物学家Michael Fessler说:“我绝不会告诉患者因为有了他汀类药物就可以继续吸烟,也不能仅根据一项研究结果就得出结论。”现在还没有确凿的证据证明该类药物可以防止肺癌的发生。但是这可以让有肺病的吸烟者花多年的时间去戒烟,英国格拉斯哥大学呼吸病学教授Neil Thomson说,因此,他汀类药物可以在建议患者戒烟的这段时间里给患者服用。

他汀类药物能阻断羟甲基戊二酸单酰辅酶A还原酶,该酶与多种脂肪的产生有关,阻断该酶可以降低胆固醇水平。他汀类药物也可以降低刺激(如吸烟)引起的炎症分子浓度,从而减轻肺部炎症反应。该类药物还可用于保护非吸烟者的肺,如抑止哮喘和慢性阻塞性肺病,一项新的研究已在验证此设想。

研究人员希望他汀类药物可以用于抑止其他炎性疾病,如风湿性关节炎。“我相信在未来几年里,他汀类药物的应用领域将更加广泛,”Fessler说。

Cholesterol drugs protect smokers' lungs

Statins used to lower cholesterol may also ease inflammation caused by smoke.

Cholesterol drugs called statins could protect smokers from some of the lung damage inflicted by their habit, a team of researchers report today.

Their study of smokers and former smokers showed that patients who took statins were 35% less likely to need hospitalization or a visit to the emergency room for lung-related illness than those not taking the drugs.

Statins are a group of blockbuster drugs best known for lowering cholesterol and warding off heart disease. But over the past decade, researchers have come to appreciate that they also seem to reduce inflammation — and animal tests have hinted that they can protect the lungs.

Walid Younis at the University of Oklahoma Medical Center in Oklahoma City and his colleagues examined the medical records of 485 smokers and former smokers. They compared medical tests of the patients' lung health with those done, on average, 2.7 years previously.

The lungs of those who were taking statins fared much better. Their lung volume, for example, had declined by just over 1% each year compared with a drop of 10% in the comparison group. "We were really impressed," says Younis, who presented the results at the American College of Chest Physicians meeting in Salt Lake City, Utah.

Pill popping

The connection now needs to be tested more rigorously in a randomized clinical trial. If it holds up, it suggests that smokers could avert some of the harm done by cigarettes with a pill already known to be safe. No other drug is known to protect against smoke-related lung damage.

Experts are keen to emphasize that taking statins will never be as beneficial as quitting the habit altogether. "I would never tell a patient it's OK to continue smoking because they're on statins, and certainly not from this one study," says respiratory biologist Michael Fessler at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. And there is no firm evidence that the drugs protect against lung cancer.

But it can take smokers diagnosed with lung disease many years to kick the habit, says Neil Thomson, professor of respiratory medicine at the University of Glasgow, UK. So statins might be prescribed during this period, alongside advice to quit.

Smoke break

Statins block an enzyme called HMG-CoA reductase, which is involved in the production of various fatty molecules. Blocking this enzyme lowers cholesterol levels. It also reduces the concentration of molecules that promote inflammation in response to irritants such as smoke.

The drugs might also be used to protect the lungs of non-smokers against such diseases as asthma and chronic obstructive pulmonary disease. A few studies are already testing this idea.

Researchers are hopeful that statins might help in other inflammatory diseases such as rheumatoid arthritis. "I do think their application will broaden over the next few years," Fessler says.

新闻来源:http://www.nature.com/news/2006/061023/full/061023-1.html

编辑:蓝色幻想

编辑: 张靖

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