呼吸器関連肺炎患者の死亡率に対するスタチン治療の効果:ランダム化臨床試験
Laurent Papazian1, Antoine Roch, Pierre-Emmanuel Charles
1Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections Sévères UMR-CNRS 7278, Aix-Marseile Université, Marseille, France.
JAMA
|October 11, 2013
まとめ
シムバスタチンは,呼吸器関連肺炎 (VAP) の患者の生存率を改善しませんでした. このランダム化試験では,28日目の死亡率の有意な減少は認められず,スタチンはVAPのアウトカムに有益ではないことを示唆しています.
科学分野:
- クリティカルケア・メディシン
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
背景:
- 観察研究では,スタチンの使用が様々な感染症の治療結果を改善することが示唆されています.
- 呼吸器関連性肺炎 (VAP) は,集中治療室 (ICU) で発生する一般的な,しばしば致命的な感染症です.
研究 の 目的:
- スタチン療法 (シムバスタチン) がVAPと診断された患者の28日間の死亡率を低下させるかどうかを調査する.
主な方法:
- 多センター,ランダム化,プラセボ対照,ダブルブラインド試験で,VAPの疑いのある300人の患者が機械呼吸器を必要とする.
- 患者は,ICU退院,死亡,または28日目まで,毎日シムバスタチン (60mg) またはプラセボを投与されました.
- 主なアウトカムは28日間の死亡率であり,次要アウトカムには他の死亡率と機械呼吸器の使用期間が含まれていました.
主要な成果:
- 裁判は徒然と判断され,早期に中止された. 28日目の死亡率は,シムバスタチン投与では21.2%であり,プラセボ投与では15.2%であった (P=.10).
- スタチン未使用の患者では,シンバスタチン投与の28日間の死亡率は21.5%で,プラセボ投与の13.8% (P=0.054) であった.
- 14日目,ICU,または病院での死亡率,または機械呼吸器の持続時間において有意な違いは観察されなかった.
結論:
- 補助的なシムバスタチン治療は,VAPの疑いのある成人の28日間の生存率を改善しませんでした.
- これらの発見は,VAPのアウトカムを改善するためにスタチンの使用を支持しません.
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