Trubelja Nenad, Vaughan Carl, Coplan Neil L
Division of Cardiovascular Medicine, Department of Medicine, Lenox Hill Hospital, New York, NY 10021, USA.
Prev Cardiol. 2005 Spring;8(2):98-101. doi: 10.1111/j.1520-037x.2005.3568.x.
Epidemiological studies have not demonstrated a clear relationship between stroke risk and hypercholesterolemia. Clinical trials using statins have demonstrated a reduction in stroke, in particular, in patients with established coronary artery disease. The disparity between epidemiological and clinical studies suggests hypercholesterolemia is a true risk factor for stroke that evaded detection in epidemiological studies, or that statins possess other properties that render them useful in stroke prevention. These effects have been loosely termed "pleiotropic" in the lipid literature and revolve around putative effects of statins on endothelial function, inflammation, thrombosis, plaque stability, and immune regulation. Questions remain as to the mechanisms of benefit of statin therapy in stroke prevention, the role of statins in the primary prevention of stroke, and the role of statins in modulating the immune system in the brain.
流行病学研究尚未证实中风风险与高胆固醇血症之间存在明确关联。使用他汀类药物的临床试验已证明中风发生率有所降低，尤其是在已确诊患有冠状动脉疾病的患者中。流行病学研究与临床研究之间的差异表明，高胆固醇血症是中风的一个真正危险因素，只是在流行病学研究中未被发现，或者他汀类药物具有其他特性使其在预防中风方面有用。在脂质文献中，这些作用被宽泛地称为“多效性”，并围绕他汀类药物对内皮功能、炎症、血栓形成、斑块稳定性和免疫调节的假定作用展开。关于他汀类药物治疗在预防中风中的获益机制、他汀类药物在中风一级预防中的作用以及他汀类药物在调节大脑免疫系统中的作用，仍存在疑问。
