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目的评价他汀类药物对蛛网膜下腔出血患者迟发性脑血管痉挛的预防作用。方法通过关键词“Statin”和“Subarachnoid hemorrhage”及对应的中文关键词“他汀”和“蛛网膜下腔出血”分别搜索Pubmed数据库、EMBASE数据库、OVID循证数据库、中国期刊网等中英文数据库,寻找研究指标包括迟发性脑血管痉挛的研究,应用Review Manager4.2软件进行分析。结果共获取符合要求的文献5篇,含2篇中文文献;3项研究采用了安慰剂对照;使用他汀类药物对于蛛网膜下腔出血患者发生迟发性脑血管痉挛的比值比(OR)为0.34,95%CI;0.20-0.60,P=0.0002;有统计学意义。他汀类药物对于蛛网膜下腔出血患者死亡的OR值为0.67,95%CI;0.33-1.39,P=0.29,无统计学意义。结论目前文献支持他汀类药物可有效预防蛛网膜下腔出血患者发生迟发性脑血管痉挛,且对病死率无明显影响。
Objective To evaluate the preventive effect of statins on delayed cerebral vasospasm in patients with subarachnoid hemorrhage. Methods The Pubmed database, the EMBASE database, the OVID evidence-based database were searched by the keywords “Statin” and “Subarachnoid hemorrhage” with the corresponding Chinese keywords “statin” and “subarachnoid hemorrhage” China Journal Net and other databases in English, looking for research indicators, including studies of delayed cerebral vasospasm, using Review Manager4.2 software for analysis. Results A total of 5 articles were obtained, 2 Chinese articles were included, 3 placebo-controlled studies were performed, and the odds ratio (OR) for statin-delayed cerebral vasospasm in patients with subarachnoid hemorrhage was 0.34, 95% CI; 0.20-0.60, P = 0.0002; with statistical significance. The OR of statin for death in patients with subarachnoid hemorrhage was 0.67, 95% CI; 0.33-1.39, P = 0.29, which was not statistically significant. Conclusion The current literature supports that statins can effectively prevent delayed cerebral vasospasm in patients with subarachnoid hemorrhage and has no significant effect on mortality.