Brain Injury Research Group, School of Biomedicine, University of Manchester, UK.
Int J Stroke. 2012 Feb;7(2):150-6. doi: 10.1111/j.1747-4949.2011.00740.x.
Statins are postulated as candidate drugs for the treatment of acute stroke. The aim of this study was to critically appraise the evidence for the efficacy of statins administered after the onset of experimental focal cerebral ischemia.
We undertook a systematic review and meta-analysis of animal studies reporting the efficacy of any statin administered following middle cerebral artery occlusion. The primary outcome measure was infarct volume. Assessment of study quality and range of evidence were undertaken, and prespecified sub-group analyses were performed.
Eighteen published studies describing outcome in 472 animals were identified. Statins reduced infarct volume by 11.2% (95% confidence interval 8.1% to 14.3%, P < 0.001) and improved the neurological severity score by 0.7 points (95% confidence interval 0.4 to 1.1, P < 0.0001). Efficacy was evident up to three-hours post-middle cerebral artery occlusion. Median study quality score was 7 of 13 (interquartile range, 4 to 11). No studies tested efficacy in aged, female, or hypertensive animals; or in species other than rodents.
These findings suggest that statins administered after middle cerebral artery occlusion have modest efficacy. Effects of potential sources of bias are considered likely to reduce the estimated effect from this review.
他汀类药物被认为是治疗急性中风的候选药物。本研究旨在批判性地评估在实验性局灶性脑缺血发作后给予他汀类药物的疗效证据。
我们对报道了任何他汀类药物在大脑中动脉闭塞后给药的疗效的动物研究进行了系统评价和荟萃分析。主要结局指标为梗死体积。评估了研究质量和证据范围，并进行了预定的亚组分析。
确定了 18 项已发表的研究，这些研究描述了 472 只动物的结果。他汀类药物使梗死体积减少了 11.2%（95%置信区间 8.1%至 14.3%，P < 0.001），并使神经严重程度评分提高了 0.7 分（95%置信区间 0.4 至 1.1，P < 0.0001）。在大脑中动脉闭塞后三小时内即可观察到疗效。中位数研究质量评分为 13 分（四分位距，4 至 11）。没有研究在老年、女性或高血压动物中测试疗效；或在非啮齿动物中测试疗效。
这些发现表明，在大脑中动脉闭塞后给予他汀类药物具有适度的疗效。潜在偏倚来源的影响被认为可能会降低本综述中估计的效果。
