Vuorio Alpo, Kaste Markku, Kovanen Petri T
Medical Health Center Mehiläinen Airport, Vantaa, Finland and Finnish Institute of Occupational Health (FIOH), Lappeenranta, Finland.
Department of Neurology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
Int J Stroke. 2015 Jun;10(4):467-8. doi: 10.1111/ijs.12492.
It is estimated that worldwide, around 35 million people have familial hypercholesterolemia (FH). Thus, patients affected by the combination of FH and acute intracerebral hemorrhage (ICH) are not exceptional and neurologists should be prepared to encounter them. Despite a recent finding of beneficial association between statin use during hospitalization and improved outcomes, the increased risk of recurrent ICH in the long term may make clinicians avoid statins in patients with a history of ICH. However, discontinuing statins in patients with FH worsens cardiovascular outcomes and even increases all-cause mortality. Accordingly, the continuing statin treatment in an FH patient with an acute ICH is advisable.
据估计，全球约有3500万人患有家族性高胆固醇血症（FH）。因此，受FH和急性脑出血（ICH）共同影响的患者并不罕见，神经科医生应做好接诊此类患者的准备。尽管最近有研究发现住院期间使用他汀类药物与改善预后之间存在有益关联，但长期复发性ICH风险增加可能会使临床医生避免在有ICH病史的患者中使用他汀类药物。然而，在FH患者中停用他汀类药物会使心血管预后恶化，甚至增加全因死亡率。因此，对于急性ICH的FH患者，继续使用他汀类药物治疗是可取的。
