Division of Internal Medicine, ASL 1 Umbria, via Engels-Voc.Chioccolo, 06012 Città di Castello (Perugia), Italy.
Intern Emerg Med. 2012 Aug;7(4):305-11. doi: 10.1007/s11739-011-0603-x. Epub 2011 May 5.
Although evidence from epidemiological studies examining a relationship between cholesterol level and stroke is less than definitive, there is a compelling evidence from the clinical therapy trials primarily designed to examine the coronary benefits of statins that statin therapy also causes a reduction in the risk of stroke. Even though a stroke does not have the same exact pathophysiology as a heart attack, specific trials in stroke patients confirm advantages and risks of statin therapy in this kind of population. In primary prevention, statins are effective both when low-density lipoprotein (LDL) is raised and when hs-CRP is elevated. In secondary prevention, an absolute reduction of recurrent stroke can be obtained with statins, with a number needed to treat at 5 years of 45.
尽管流行病学研究中关于胆固醇水平与中风之间关系的证据还不够明确，但主要用于检查他汀类药物对冠心病益处的临床治疗试验提供了强有力的证据，表明他汀类药物治疗也可降低中风风险。尽管中风与心脏病发作的病理生理学不完全相同，但针对中风患者的具体试验证实了他汀类药物治疗在这类人群中的优势和风险。在一级预防中，当低密度脂蛋白（LDL）升高和高敏 C 反应蛋白（hs-CRP）升高时，他汀类药物都有效。在二级预防中，他汀类药物可绝对降低复发性中风的风险，5 年内所需治疗人数为 45 人。
