他汀类药物治疗对急性缺血性脑卒中预后的影响  

Effects of statin therapy on the outcome of acute ischemic stroke： a meta-analysis

作　　者：韦朝霞[1] 潘速跃[2] 祁风[1] 余科[1] 刘祖佑[1] 

机构地区：[1]广州医科大学附属第三医院北院神经内科,广州510170 [2]南方医科大学南方医院神经内科,广州510515

出　　处：《中华行为医学与脑科学杂志》2016年第5期476-480,共5页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：广州市科信局项目(20124414123)Guangzhou Science Technology and Innovation Project

摘　　要：目的 用meta分析的方法,对已发表的关于他汀治疗在缺血性脑卒中急性期的应用研究中定量分析其对改良Rankin评分（modified Rankin Scale,mRS）和死亡率的影响,以探讨他汀类药物治疗与急性缺血性脑卒中临床预后与死亡率的关系,为他汀在缺血性脑卒中急性期治疗的作用提供理论依据.方法 从Cochrane Library、Medline和Embase数据库中,检索发表的全部关于他汀治疗急性缺血性脑卒中的随机对照研究（RCT）和观察性队列研究（OTs）,对其进行meta分析.所有数据用RevMan5.3Meta软件处理,研究之间的异质性进行Q检验和I^2检验,用Egger检验评估发表偏倚.结果 共27项符合纳入标准研究纳入本研究,共52 034例患者,包括19212例他汀使用者和32 822例非使用者,其中4项研究是随机对照试验,23项观察性研究.缺血性脑卒中急性期使用他汀治疗可减少发病后第90天死亡率,他汀治疗可改善AIS患者出院时及发病90d的功能预后.观察性研究的结果与随机对照研究结果一致.结论 缺血性脑卒中急性期使用他汀类药物治疗,包括发病前已开始使用及发病后72 h开始使用,均可显著降低死亡率并改善预后,他汀治疗是确实有效的.Objective To analyze quantitatively the safety and efficacy of statin therapy in acute phrase for acute ischemic stroke with the method of meta-analysis.Methods We performed a systematic literature search including the Cochrane Library,MEDLINE and EMBASE for published trials about statin therapy and the outcomes of acute ischemic stroke.Then we performed a meta-analysis with included studies to investigate the association between statin therapy and clinical outcome and mortality.All of the data were pooled and meta-analyzed by Cochrane Collaboration RevMan 5.3 meta-analysis software.Statistical heterogeneity between studies was evaluated by the chi-square and I-square tests.Forest plots were used to summarize study data and Egger tests were used to assess publication bias.Results A total of 27 studies including 52 034 patients,comprising 19 212 statin users and 32 822 non-statin users met the inclusion criteria,4 studies were randomized controlled trials （RCTs）,and 23 were observational trials （OTs）.Both pre-or post-stroke statin use was associated with reduced mortality.Statin use is associated with favorable functional outcome at hospital discharge and on the ninetieth day regardless of initiation time for pre-stroke group and post-stroke group.The results from observational trials were consistent with randomized controlled trials.There was no evidence of publication bias for all comparisons by Egger tests.Conclusions Statin therapy before or after AIS is safe and effective.

关 键 词：他汀治疗 急性缺血性脑卒中 改良mRS评分 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]