Kern Michael, Lam Mark M F, Knuckey Neville W, Lind Christopher R P
West Australian Neurosurgical Service of Sir Charles Gairdner and Royal Perth Hospitals, Hospital Avenue, Nedlands, Western Australia 6009, Australia.
J Clin Neurosci. 2009 Apr;16(4):527-30. doi: 10.1016/j.jocn.2008.08.001. Epub 2009 Feb 23.
Statins have been shown in two recent small phase I/II trials to be associated with a marked reduction in clinical and transcranial Doppler (TCD) evidence of vasospasm after aneurysmal subarachnoid haemorrhage (SAH). The purpose of this study was to assess the clinical impact of this treatment in a larger number of patients. Fifty-eight individuals were treated in the year before, and 72 patients treated in the year after, the introduction of a 2week course of 40mg/day pravastatin therapy for SAH. Statins did not result in reduced TCD velocities, clinical or angiographic vasospasm, or improvements in global outcome at the time of hospital discharge. A measurable reduction in the rates of vasospasm was expected, based on the size of the effect of statin therapy in the previous small studies. There remains significant uncertainty as to the role of statins in preventing vasospasm after SAH.
近期两项小型I/II期试验表明，他汀类药物与动脉瘤性蛛网膜下腔出血（SAH）后血管痉挛的临床及经颅多普勒（TCD）证据显著减少有关。本研究的目的是评估该治疗方法对更多患者的临床影响。在引入为期2周、每日40mg普伐他汀治疗SAH的方案之前的一年中有58人接受治疗，之后的一年中有72名患者接受治疗。他汀类药物并未使TCD速度降低、临床或血管造影血管痉挛减轻，也未改善出院时的整体预后。基于之前小型研究中他汀类药物治疗效果的规模，预计血管痉挛发生率会有可测量的降低。关于他汀类药物在预防SAH后血管痉挛中的作用仍存在很大不确定性。
