Osseby G V, Manceau E, Lemesle-Martin M, Thomas V, Giroud M
Unité d'Urgence Cérébro-Vasculaire, Service de Neurologie, CHU, 3, rue du Faubourg Raines, 21000 Dijon.
Ann Endocrinol (Paris). 2001 Feb;62(1 Pt 2):113-20.
The role of cholesterol in the pathogenesis of stroke, the role of the treatment of hypercholesterolemia in the prevention of stroke have been controversed. The explanation was based on the heterogenous characteristics of stroke, on the relationship between several risk factors, and on the role of the age, in the evaluation of these 2 questions. The discovery of statins induced major therapeutic trials whose aim was the impact on coronary events. These trials demonstrated that statins were accompanied with a major reduction of cholesterol levels and stroke events similar to the one observed with coronary events. Even prospective, placebo controlled, randomized specific trials for stroke are necessary, we can state that cholesterol reduction is the most important mechanism accounting for a decrease in stroke occurrence with statins.
胆固醇在中风发病机制中的作用，以及高胆固醇血症治疗在预防中风中的作用一直存在争议。这种争议基于中风的异质性特征、多种风险因素之间的关系以及年龄在评估这两个问题时所起的作用。他汀类药物的发现引发了主要的治疗试验，其目的是评估对冠状动脉事件的影响。这些试验表明，他汀类药物可使胆固醇水平大幅降低，中风事件也随之显著减少，类似于在冠状动脉事件中观察到的情况。尽管仍需要针对中风进行前瞻性、安慰剂对照、随机的特异性试验，但我们可以认为，降低胆固醇是他汀类药物减少中风发生的最重要机制。
