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他汀类药物用于预防高危患者的癫痫发作和癫痫:队列研究的系统评价和荟萃分析。

Statin use for the prevention of seizure and epilepsy in the patients at risk: A systematic review and meta-analysis of cohort studies.

作者信息

Guo Yu, Zhu Ling-Hong, Zhao Kai, Guo Xin-Mei, Yang Ming-Fei

机构信息

Graduate School, Qinghai University, Xining, Qinghai, 810016, PR China.

Department of Science and Education, Qinghai Provincial People's Hospital, Xining, Qinghai, 810007, PR China.

出版信息

Epilepsy Res. 2021 Aug;174:106652. doi: 10.1016/j.eplepsyres.2021.106652. Epub 2021 May 4.

Abstract

OBJECTIVE

Statin use for the prevention of seizure and epilepsy had been suggested but remained controversial. We sought to search existing literature to determine whether prophylactic use of statin reduced the incidence of seizure and epilepsy in the patients at risk.

METHODS

Three electronic databases were thoroughly searched to identify clinical studies investigating the effects of statin use on patients at the risk of seizure or epilepsy. Regardless of heterogeneity quantified, a random effects meta-analyses were used to synthesize the evidence, to pool odds ratios (ORs) and corresponding 95 % confidence intervals (CIs).

RESULTS

Seven cohort studies involving 26,042 patients with newly-onset epileptogenic brain insults and no history of seizure and epilepsy before were included. Compared with patients didn't receive statin treatment after epileptogenic brain insults, those treated with statin had a lower risk of epilepsy (5 studies; 22,849 patients; pooled OR, 0.48; 95 % CI, 0.31 to 0.73; p =  0.001) and seizure (4 studies; 6076 subjects; pooled OR, 0.35; 95 % CI, 0.25 to 0.48; p =  0.001).

CONCLUSIONS

Evidence from this meta-analysis suggested that the use of statin should as primary prevention for patients with risk of seizures and epilepsy. Considering the limited number and quality of available studies, future randomized controlled trials are required to further demonstrate the association between statin use and incident of seizure and epilepsy.

摘要

目的

他汀类药物用于预防癫痫发作和癫痫已被提出,但仍存在争议。我们试图检索现有文献,以确定预防性使用他汀类药物是否能降低有风险患者的癫痫发作和癫痫发病率。

方法

全面检索三个电子数据库,以识别研究他汀类药物对有癫痫发作或癫痫风险患者影响的临床研究。无论量化的异质性如何,均采用随机效应荟萃分析来综合证据,汇总比值比(OR)和相应的95%置信区间(CI)。

结果

纳入了7项队列研究,涉及26042例新发致癫痫性脑损伤且既往无癫痫发作和癫痫病史的患者。与致癫痫性脑损伤后未接受他汀类药物治疗的患者相比,接受他汀类药物治疗的患者癫痫发作风险较低(5项研究;22849例患者;汇总OR,0.48;95%CI,0.31至0.73;p = 0.001),癫痫发作风险也较低(4项研究;6076名受试者;汇总OR,0.35;95%CI,0.25至0.48;p = 0.001)。

结论

这项荟萃分析的证据表明,他汀类药物应用于癫痫发作和癫痫风险患者的一级预防。考虑到现有研究数量和质量有限,未来需要进行随机对照试验,以进一步证明他汀类药物使用与癫痫发作和癫痫发病之间的关联。

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