阿托伐他汀与阿司匹林联合用药预防缺血性脑卒中复发效果的Meta分析

Efficacy of atorvastatin combining aspirin in prevention of ischemic stroke recrudescence: a Meta-analysis

目的系统评价阿司匹林与阿托伐他汀联合用药预防缺血性脑卒中复发以及卒中后短暂性脑缺血发作的疗效。方法通过计算机检索Web of Science、Pub Med、EMbase、Cochrane Library、维普、中国知网、万方等数据库,搜集符合要求的随机对照试验研究,提取效应指标和相关资料,采用stata14.0统计软件进行Meta分析。结果共纳入28篇文献,包括3999例缺血性脑卒中患者。纳入的28篇文献均报告了脑卒中复发危险性,经Meta分析结果显示,与单独用阿司匹林组相比,阿托伐他汀和阿司匹林联合用药组缺血性脑卒中复发风险为(RR=0.36,95%CI:0.30~0.43,P<0.001);有8个研究报告脑卒中后短暂性脑缺血发作的风险,与单独用药相比,联合用药短暂性脑缺血发作风险(RR=0.42,95%CI:0.29~0.59,P<0.001)。结论阿司匹林与阿托伐他汀联合用药相比阿司匹林单独用药可以降低缺血性脑卒中患者的缺血性卒中的复发风险,降低短暂性脑缺血的发作风险。

Objective To review systematically the curative effect of aspirin combining atorvastatin in preventions of ischemic stroke recrudescence and transient ischemic attack(TIA)after stroke.Methods The databases of Web of Science,PubMed,EMbase,Cochrane Library,VIP,CNKI and WanFang were retrieved with computer for collecting eligible randomized controlled trials(RCT).The effective indexes and relative data were extracted and given a Meta-analysis by using stata14.0software.Results There were totally28documents included involved3999patients with ischemic stroke.All included28documents reported the risk of stroke recrudescence.The Meta-analysis showed that the risk of stroke recrudescence was decreased in aspirin combiningatorvastatin group(RR=0.36,95%CI:0.30-0.43,P<0.001)compared with aspirin group.The risk of TIA after stroke was decreased in aspirin combining atorvastatin group(RR=0.42,95%CI:0.29-0.59,P<0.001)compared with aspirin group reported in8study reports.Conclusion Aspirin combining atorvastatin can reduce the risks of ischemic stroke recrudescence and TIA after stroke compared with single aspirin in patients with ischemic stroke.