他汀类药物预防卒中再发的系统评价  

Use of Statins for Preventing Stroke Recurrence:A Systematic Review

作　　者：郭佳[1,2] 田金徽[1] 杨克虎[1] 任尧尧[1] 姜雷[1] 石正洪[2] 

机构地区：[1]兰州大学循证医学中心,兰州730000 [2]兰州大学第二医院,兰州730030

出　　处：《中国循证医学杂志》2009年第5期565-569,共5页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价他汀类药物预防脑卒中再发的临床疗效。方法计算机检索Cochrane Library、PubMed、EMbase、CBM、CSJD、CJFD等数据库,并辅以手工和其他检索,收集全世界关于他汀类药物预防卒中再发的随机对照试验,检索时间截至2008年5月。由两名研究者独立提取资料,根据Cochrane Handbook4.12的质量评价标准筛选试验、评价质量和提取资料,用RevMan5.0进行统计学分析。结果共纳入6个随机对照试验,包括9675例患者。结果显示:与安慰剂相比,他汀类药物在预防卒中复发率[RR=0.94,95%CI(0.84,1.04),P=0.21]、致死性卒中发生率[RR=0.77,95%CI(0.48,1.25),P=0.30]方面差异无统计学意义;在短暂性脑缺血发作发生率[RR=0.80,95%CI(0.69,0.92),P=0.002]方面差异有统计学意义。结论当前证据表明,他汀类药物预防卒中再发及致死性卒中发生效果不佳,但可预防短暂性脑缺血发作。Objective To assess the clinical efficacy of statins for preventing stroke recurrence. Methods We searched The Cochrane Library, PubMed, EMbase, CBM, CSJD, and CJFD for randomized controlled trials on the use of statin drugs to prevent stroke recurrence （up to May 10, 2008）, and manually searched key Chinese magazines in the related fields. Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane handbook 4.12. RevMan 5.0 software was used for data analysis. Results Six randomized controlled trials involving 9,675 patients were identified. The results of meta-analysis showed that there was no statistical difference in stroke recurrence rate （RR=0.94, 95%CI 0.84 to 1.04, P=0.21） and fatal stroke occurrence （RR=0.77, 95%CI 0.48 to 1.25, P=0.30） between statins and placebo groups, but a significant difference was found between the two groups in transient ischemic attack occurrence （RR=0.80, 95%CI 0.69 to 0.92, P=0.002）. Conclusion Current evidence indicates that statin drugs have no superiority to prevent stroke recurrence and fatal stroke occurrence, but can prevent transient ischemic attack

关 键 词：卒中 再发 他汀类药物 系统评价 

分 类 号：R743[医药卫生—神经病学与精神病学]