Yoon Sung Sug, Dambrosia James, Chalela Julio, Ezzeddine Mustapha, Warach Steven, Haymore Joseph, Davis Lisa, Baird Alison E
Stroke Neuroscience Unit, NINDS/NIH, Bethesda, MD 20892, USA.
BMC Med. 2004 Mar 23;2:4. doi: 10.1186/1741-7015-2-4.
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome.
This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score < 2 at discharge. Statistical analyses used univariate and multivariate logistic regression models.
There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22%) of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03). After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2-6.7) of a good outcome at the time of hospital discharge.
The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.
他汀类药物（3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂）在实验性中风模型中具有神经保护作用，并且在临床实践中常用。本研究的目的是确定中风入院前服用他汀类药物的患者是否有改善的临床结局。
这是一项对2000年7月至2002年12月期间入住美国国立卫生研究院郊区医院中风项目的436例患者的观察性研究。入院时获取自我报告的中风危险因素。中风严重程度由入院时的美国国立卫生研究院中风量表评分确定。良好结局定义为出院时Rankin评分<2。统计分析使用单变量和多变量逻辑回归模型。
共有436例最终诊断为缺血性中风的患者；其中433例有他汀类药物数据。总共95/433（22%）的患者入院时正在服用他汀类药物，从2000年的16%上升到2002年的26%。服用他汀类药物的患者中有51%有良好结局，而未服用他汀类药物的患者为38%（p = 0.03）。在调整混杂因素后，他汀类药物预处理与出院时良好结局的2.9倍优势（95%CI：1.2 - 6.7）相关。
中风入院时服用他汀类药物的患者比例正在迅速上升。他汀类药物预处理与出院时改善的功能结局显著相关。这一发现可能支持中风后早期开始他汀类药物治疗。
