他汀类减少肾癌风险

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Statins May Reduce Risk of Kidney Cancer
NEW YORK (Reuters Health) Feb 26 - Treatment with statins appears to reduce the risk of renal cell carcinoma, according to the results of a case-control study of nearly 500,000 veterans.
路透社2008年2月26日纽约讯——根据对500,000 退伍军人的病例对照研究，他汀类可以减少患肾细胞癌的风险。
Evidence from animal models and in vitro experiments suggests that HMG-coA reductase inhibitors are capable of suppressing tumor growth. Moreover, prior research has indicated a protective benefit against bladder cancer and prostate cancer with statin therapy.
动物模型及体外实验结果显示，HMG-COA还原酶抑制剂能抑制肿瘤的生长。而且，以往的研究表明他汀类对于预防膀胱癌和前列腺癌有一定作用。
Given this apparent activity against these genitourinary malignancies, Dr. Murali Ankem, from the Overton Brooks VA Medical Center in Shreveport, Louisiana, and colleagues examined whether statins might protect against renal cell carcinoma. The researchers report their findings in the January issue of Urology.
鉴于他汀类药物对泌尿生殖系恶性肿瘤的显著作用，来自Overton Brooks VA Medical Center in Shreveport, Louisiana的Murali Ankem博士和同事研究了他汀类药物能否预防肾癌，该研究结果发表在《Urology》杂志一月刊上。
In the VA database, 34% of subjects were statin users and 0.3% of subjects had a primary diagnosis of renal cell carcinoma, the report indicates.
报告显示，在VA数据库中，有34% 受试者服用他汀类药物，其中0.3% 受试者初步诊断为肾细胞癌。
Treatment with a statin was associated with a 48% reduced risk of renal cell carcinoma. Moreover, this reduced risk was still apparent after adjusting for age, sex, smoking, and obesity.
服用他汀类药物可使患肾细胞癌风险下降48% ，经校正年龄、性别、吸烟、肥胖等因素后，其降低风险的效果仍很明显。
Randomized controlled trials are now needed to verify these findings and to determine whether statins will have any role in the prevention and treatment of renal cell carcinoma, the authors conclude.
笔者认为，有关他汀药是否在预防和治疗肾细胞癌上有确切的作用，还需要更多的随机对照试验去证实。
Urology 2008;71:118-122.（泌尿外科2008 ; 71:118-122 ）

现在已经有越来越多的资料显示，他汀类有许多降脂外的其它作用，如抗炎作用，改善内皮功能，抗肿瘤作用，抗心率失常，抗骨质疏松，减少尿蛋白等作用。他汀类药物的不良反应有胃肠道不适，头痛，皮疹，胀气，头晕，视觉模糊和味觉障碍。最主要的不良反应是肝脏转氨酶升高和肌病，在肝脏毒性方面主要表现为用药期间丙氨酸转氨酶（ALT）升高和天冬氨酸转氨酶（AST），约有1%的患者转氨酶指标会超过正常上限的3倍，多发生于最初用药3个月内，停药后相关酶学指标即可恢复正常。他汀类药物有一定的肾脏保护作用，但是没有向ACEI那样得到询证医学的证实，