摘要
【目的】探讨他汀类药物对脑卒中的预防作用。【方法】通过检索国内外文献数据库,检索2002年1月至2010年1月已经发表关于他汀的临床随机对照试验,对其进行meta分析。【结果】共纳入随机对照试验16个,高危人群中,他汀组比对照组所有脑卒中发生率降低13%(95%CI 3%～22%,P=0.01),作分层处理,肾病血透及肾移植病人所有脑卒中发生率增加21%(95%CI 0%～46%,P=0.05),另一层为除外肾病血透和肾移植病人的高危人群,所有脑卒中发生率降低19%(95%CI 13%～24%,P<0.001),他汀组比对照组致死性卒中发生率降低16%(95%CI 0～30%,P=0.05),出血性卒中发生率的RR值1.18(95%CI 0.92-1.50,P=0.19),两组之间出血性卒中发生率的差别无统计学意义。【结论】他汀类药物能降低脑卒中的发生率和死亡率,对脑出血没有预防作用,不会增加脑出血发生率。但肾病血透病人及肾移植病人、有脑出血病史的病人使用他汀要慎重。
【Objective】To analyze the effects of statins for prevention of stroke.【Methods】 Electronic databases from January 2002 to January 2010 about randomized controlled trial of statins were collected and meta-analysis of these randomized controlled trial was used.【Results】 A total of 16 trials is included.Compared with control treatment,statin treatment reduced the risk of all stroke by 13%（95% CI 3% ～ 22%,P = 0.01）.After stratified,the morbidity of all stroke in patients with renal transplant and receiving haemodialysis because of nephropathy was increased by 21%（95% CI 0 ～ 46%,P = 0.05）,and one of other stroke in patients was reduced by 19%（95% CI 13% ～ 24%,P 0.001）.Compared with control treatment,statin treatment reduced the morbidity of fatal stroke by 16%（95% CI 0% ～ 30%,P = 0.05）.There is not statistically significant about the morbidity of intracerebral haemorrhage between statin and control group（RR 1.18,95% CI 0.92-1.50,P=0.19）.【Conclusion】 Statins can reduce the morbidity and mortality of stroke,but it can not prevent intracerebral haemorrhage and not increase the morbidity of intracerebral haemorrhage.However,we should be careful to use statins in patients with renal transplant and receiving haemodialysis because of nephropathy and history of intracerebral haemorrhage.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2011年第1期126-130,138,共6页
Journal of Sun Yat-Sen University:Medical Sciences
基金
国家自然科学基金(30971027)
