Sawada Naoki, Itoh Hiroshi, Nakao Kazuwa
Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine.
Nihon Rinsho. 2002 May;60(5):993-1001.
The correlation between stroke incidence and serum lipid level has been equivocal, and conventional lipid-lowering agents such as fibrates were ineffective for stroke prevention. Recent clinical trials for HMG-CoA reductase inhibitors(statins) have demonstrated 20-30% reduction in the risk of cerebrovascular events and mortality in the population with previous coronary heart disease(CHD). The beneficial effect of statins was most evident for thromboembolic stroke, and no significant increase in hemorrhagic events was noted. Equal reduction in stroke risk was observed between hyper- and normocholesterolemic populations, indicating the non-lipid mechanisms of statins. The efficacy and safety of statin treatment make it a promising approach for the management of both CHD and non-CHD patients at high risk of stroke, especially the elderly.
中风发病率与血清脂质水平之间的相关性一直不明确，而传统的降脂药物如贝特类药物对预防中风无效。最近针对HMG-CoA还原酶抑制剂（他汀类药物）的临床试验表明，在既往有冠心病（CHD）的人群中，脑血管事件风险和死亡率降低了20%-30%。他汀类药物对血栓栓塞性中风的有益作用最为明显，且未发现出血事件显著增加。在高胆固醇血症和正常胆固醇血症人群中观察到中风风险同等程度降低，这表明他汀类药物存在非脂质作用机制。他汀类药物治疗的有效性和安全性使其成为治疗CHD和中风高危非CHD患者（尤其是老年人）的一种有前景的方法。
