Neurovascular Research Laboratory, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
J Neurochem. 2012 Jul;122(2):233-43. doi: 10.1111/j.1471-4159.2012.07773.x. Epub 2012 May 21.
Protective effects of statins have been well documented for stroke therapy. Here, we used a systematic review and meta-analysis to assess these evidences. We identified 190 studies using statin treatment in stroke animal models by electronic searching. From those, only studies describing ischemic occlusive stroke and reporting data on infarct volume and/or neurological outcome were included in the analysis (41 publications, 1882 animals). The global estimate effect was assessed by Weighted Mean Difference meta-analysis. Statins reduced infarct volume by 25.12% (20.66%-29.58%, P < 0.001) and consistently, induced an improvement on neurological outcome (20.36% (14.17%-26.56%), P < 0.001). Stratified analysis showed that simvastatin had the greatest effect on infarct volume reduction (38.18%) and neurological improvement (22.94%), whereas bigger infarct reduction was observed giving the statin as a pre-treatment (33.5%) compared with post-treatment (16.02%). The use of pentobarbital sodium, the timing of statin administration, the statement of conflict of interest and the type of statin studied were found to be independent factors in the meta-regression, indicating their influence on the results of studies examining statin treatment. In conclusion, this meta-analysis provides further evidences of the efficacy of statins, supporting their potential use for human stroke therapy.
他汀类药物在中风治疗中的保护作用已有充分的文献记载。在这里,我们使用系统评价和荟萃分析来评估这些证据。我们通过电子搜索确定了 190 项使用他汀类药物治疗中风动物模型的研究。在这些研究中,只有描述缺血性闭塞性中风并报告梗死体积和/或神经功能结果数据的研究才被纳入分析(41 篇文献,1882 只动物)。通过加权均数差荟萃分析评估总体估计效果。他汀类药物可使梗死体积减少 25.12%(20.66%-29.58%,P<0.001),并一致地改善神经功能结局(20.36%(14.17%-26.56%),P<0.001)。分层分析表明,辛伐他汀对梗死体积减少(38.18%)和神经改善(22.94%)的效果最大,而与治疗后(16.02%)相比,作为预处理(33.5%)给予他汀类药物可观察到更大的梗死体积减少。戊巴比妥钠的使用、他汀类药物给药的时间、利益冲突的声明以及所研究的他汀类药物类型被发现是荟萃回归中的独立因素,表明它们对研究他汀类药物治疗效果的研究结果有影响。总之,这项荟萃分析提供了他汀类药物疗效的进一步证据,支持其在人类中风治疗中的潜在应用。