Zhu R-L, Chen Z-J, Li S, Lu X-C, Tang L-J, Huang B-S, Yu W, Wang X, Qian T-D, Li L-X
Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Eur Rev Med Pharmacol Sci. 2016 May;20(10):2090-8.
The cerebral vasospasm, delayed ischemic neurological deficit (DIND), mortality and poor neurological outcome induced by aneurysmal subarachnoid haemorrhage (SAH) remain the major causes of morbidity and mortality in aneurysmal SAH patients. The effects of statin-treated for aneurysmal SAH patients were not comprehensively assessed.
A systematically literature search was conducted in PubMed, EMBASE, ScienceDirect and Web of Science to identify relevant studies update to March 2015. Data were extracted and appraised independently by two authors. Moreover, fixed or random effects models were applied to calculate pooled results based on the degree of heterogeneity.
Nine RCTs and three observational studies with a total of 1957 patients met the inclusion criteria. The results showed that statin treatment was not associated with a decrease in the occurrence of DIND (RR: 0.81, 95% CI: 0.66-1.00, p = 0.05), mortality (RR: 0.90, 95% CI: 0.69-1.18, p = 0.46) and poor neurological outcome (RR: 1.02, 95% CI: 0.86-1.20, p = 0.84), nonetheless, had a potential effect on reducing the incidence of vasospasm (RR: 0.77, 95% CI: 0.66-0.89, p = 0.0006).
This meta-analysis indicated that the use of statins decreases the occurrence of cerebral vasospasm, whereas did not support a beneficial effect of statins on the occurrence of DIND, death or poor neurological outcomes in patients with aneurysmal SAH.
动脉瘤性蛛网膜下腔出血(SAH)所致的脑血管痉挛、迟发性缺血性神经功能缺损(DIND)、死亡率及神经功能预后不良仍是动脉瘤性SAH患者发病和死亡的主要原因。他汀类药物治疗动脉瘤性SAH患者的效果尚未得到全面评估。
在PubMed、EMBASE、ScienceDirect和Web of Science中进行系统的文献检索,以确定截至2015年3月的相关研究。由两位作者独立提取和评估数据。此外,根据异质性程度应用固定效应或随机效应模型计算合并结果。
9项随机对照试验(RCT)和3项观察性研究,共1957例患者符合纳入标准。结果显示,他汀类药物治疗与DIND发生率降低无关(RR:0.81,95%CI:0.66 - 1.00,p = 0.05)、死亡率降低无关(RR:0.90,95%CI:0.69 - 1.18,p = 0.46)以及神经功能预后不良发生率降低无关(RR:1.02,95%CI: