他汀类药物在神经外科的应用

The Application of Statins in Neurosurgery

他汀类药物常用于治疗高脂血症引起的心血管疾病。其药物多效性,对一些神经外科疾病也有积极治疗作用,效果与药物的种类和剂量有关。他汀类药物可以减少蛛网膜下腔出血患者脑血管痉挛及迟发性脑缺血的发生,降低病死率;对脑出血和脑损伤也有治疗作用。另外,大剂量他汀类药物能抑制肿瘤生长,特别是胶质瘤。但是,上述确切的机制仍需大样本、多中心研究。

Statins are drugs used to control cholesterol disorders and prevent cardiovascular diseases.Their denominated pleiotropic effects have demonstrated a broad action spectrum that might profit some neurological and neurosurgical diseases,the effects of which are correlated to dose and kind of statin.If statins are administered after subarachnoid hemorrhage,a significant lower incidence of vasospasm as well as delayed ischemic deficits and decreased mortality could be found.In other complex diseases as intracerebral hemorrhage or traumatic brain injury,the evidence for positive effects of a treatment with statin increased.Additionally,promising experimental results indicate that high statin doses are able to promote cell death in tumor cells,especially in gliomas.More trials in humans are in urgent need to finally determine if statins could contribute to the current management of neurosurgical diseases.