Fresnais David, Fure Brynjar
School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Internal Medicine, Central Hospital Karlstad, Karlstad, Sweden.
Cereb Circ Cogn Behav. 2025 Jun 29;9:100389. doi: 10.1016/j.cccb.2025.100389. eCollection 2025.
Cerebral small vessel disease (CSVD) is a chronic, progressive disorder that affects small blood vessels in the brain's white matter. This white matter damage appears on brain imaging as white matter hyperintensities (WMH). Although CSVD is often asymptomatic, it causes one fifth of strokes and nearly half of all vascular dementia cases, highlighting its clinical importance. Statins, widely used to lower lipid levels, are effective for reducing cardiovascular mortality in high-risk groups and are recommended for patients with myocardial infarction and ischemic stroke.
This systematic review and meta-analysis of randomized controlled trials aimed to evaluate the impact of statin therapy on CSVD.
A literature search was performed in PubMed, Embase, the Cochrane Library and Epistemonikos resulting in the full-text review of 86 articles, of which two were used for the meta-analysis.
A non-significant trend towards lower WMH volume in milliliters was observed in the statin group compared to controls, mean difference (MD) = -4.44 (95 % CI -10.19-1.31).
There is limited evidence available for the use of stain-treatment for CSVD, and further research is needed as well as studies on the clinical and person-centered benefits of statins on cognition and functional level in persons with CSVD.
脑小血管病（CSVD）是一种慢性进行性疾病，影响大脑白质中的小血管。这种白质损伤在脑成像上表现为白质高信号（WMH）。尽管CSVD通常无症状，但它导致五分之一的中风和近一半的血管性痴呆病例，凸显了其临床重要性。他汀类药物广泛用于降低血脂水平，对降低高危人群的心血管死亡率有效，推荐用于心肌梗死和缺血性中风患者。
本对随机对照试验的系统评价和荟萃分析旨在评估他汀类药物治疗对CSVD的影响。
在PubMed、Embase、Cochrane图书馆和Epistemonikos进行文献检索，对86篇文章进行全文回顾，其中两篇用于荟萃分析。
与对照组相比，他汀类药物组的WMH体积（毫升）有降低的非显著趋势，平均差（MD）=-4.44（95%CI -10.19-1.31）。
关于使用他汀类药物治疗CSVD的证据有限，需要进一步研究，以及关于他汀类药物对CSVD患者认知和功能水平的临床及以患者为中心益处的研究。
