他汀类药物对急性缺血性卒中预后影响的临床研究

目的 评估发病前使用他汀类药物对急性缺血性卒中发病时症状严重程度及出院时功能转归的影响.方法 回顾性分析2006年1月至10月上海交通大学医学院附属新华医院神经内科住院治疗的185例急性缺血性卒中患者的临床资料,依据发病前是否已使用他汀类药物分为他汀治疗组(57例)与非他汀治疗组(128例),对比两组的一般资料、血管危险因素、牛津郡临床分型、入院时美国国立卒中量表(NIHSS)评分、治疗方法、出院时Barthel指数等.结果 他汀治疗组入院时NIHSS评分低于非他汀治疗组(6.0对13.0,P＜0.01),出院时功能转归良好病例百分比高于非他汀治疗组(77.2%对41.1%,P＜0.01).非他汀治疗组中服用抗血小板药物者与未合并用药者比较,入院时NIHSS评分和出院时达到功能转归良好的病例百分比差异均有显著性意义(P均＜0.05).出院时功能转归良好与发病前使用他汀类药物相关(OR=5.784,P＜0.01).结论 发病前使用他汀类药物能减轻急性缺血性卒中症状及改善出院时功能转归.

Favorable outcome of ischemic stroke in patients pretreated with statins

Objective To evaluate the independent effect of premorbid statins on incident ischemic stroke severity and outcome at discharge.Methods We included consecutive patients with ischemic stroke and recorded demographic data,vascular risk factors,Oxfordshire Classification,the method of treatment National Institutes of Health Stroke Scale(NIHSS)score,previous statins treatment,and outcome discharge.We analyzed the data using univariate methods and a logistic regression with the dependent variable of good outcome(Barthel Index,BI 95 to 100).Results A total of 185 individuals met study criteria:57 patients were on statins agents prior to admission and 128 were on no statins.Pretreatment with statins was associated with lower presenting median NIHSS(6.0 vs 13.0,P<0.01).The likelihood of a good outcome was increased in those on statins after adjusting for other variables(OR=5.784,P<0.01).Conclusion Prestroke use of statins may be associated with reduced severity of incident ischemic strokes and may provide benefits for the functional outcome.However,randomized controlled trials will be required to evaluate the validity of the results.