| ABSTRACT Objective: Systematic evaluation of the effectiveness of different statins in the treatment of chronic obstructive pulmonary disease (COPD). Methods:PubMed, Web of Science, Elsevier, The Cochrane Library, CNKI and WanFang Data were electronically searched to collect cohorts and randomized controlled trials (RCTs) of long term using statins for COPD from inception to February 2018, included in relevant literature references to futher broaden the search. Two researchers independently screened literature, extracted data and assessed risk of bias of included studies, then Meta analysis was performed by Stata 12.0 software. Results:Total of 30 cohorts and RCTs, 223 823 patients were included. Meta analysis showed that, compared with conventional treatment, statins could effectively reduce the risk of COPD exacerbations (RR=0.80, 95%CI 0.73 to 0.89, P<0.001), COPD deaths (RR=0.65, 95%CI 0.47 to 0.90, P=0.009) and all cause mortality in patients with COPD (RR=0.75, 95%CI 0.66 to 0.87, P<0.001). Compared with conventional treatment, atorvastatin, fluvastatin and simvastatin all reduced pulmonary artery pressure in COPD patients with pulmonary hypertension (PH) (atorvastatin: SMD=-0.87, 95%CI -1.24 to -0.51, P<0.001; fluvastatin: SMD=-0.84, 95%CI -1.33 to -0.35, P=0.001; simvastatin: SMD=-1.16, 95%CI -1.49 to -0.83, P<0.001), and simvastatin was more effective. Conclusion:Long term use of statins for COPD is effective, and simvastatin is more effective in reducing pulmonary arterial pressure in COPD patients with PH. |
