他汀类药物与阿尔茨海默病及轻度认知功能障碍的研究进展

Research progress of Statins,Alzheimer's disease and Mild Cognitive Impairment

认知障碍对人类健康的威胁日趋严重,他汀药物作为调脂治疗的基石药物得到广泛应用,然而,关于他汀类药物对认知功能是否存在保护或损害作用一直存在较多争议。胆固醇是人脑的重要组成部分,然而不理想的血脂水平可能改变或损害神经元功能,他汀类药物可以通过调节外周及中枢神经系统内的胆固醇稳态而起到保护认知功能的作用,然而其所致的胆固醇耗竭也可能损害认知功能。目前为止大多数高级别证据倾向他汀类药物对认知功能的影响为正向或中性,更对临床前期的早期认知功能障碍可能具有保护作用。国内外指南均强调他汀类药物对有心、脑血管事件或有高风险因素的患者具有重大益处,远远超过他汀类药物导致认知障碍的不利风险。

Cognitive dysfunction increasingly serious threat to human health,statins are widely used as the cornerstone of lipid-lowering therapy,however,the effect of statins on cognitive function is still controversial.Cholesterol is an important part of the human brain,dyslipidemia may alter or impair neuronal function.Statins may generate a beneficial effect on cognition by regulating lipid levels in the peripheral and central nervous system,but cholesterol depletion may also impair cognitive function.Most of the high-level evidence so far tends to suggest that positive or neutral effects of statins on cognitive function,and may have a protective effect on early cognitive dysfunction in the preclinical stage.Overwhelming evidence in the guidelines stressed that the benefits of statin therapy far outweigh any real or perceived risks on cognition.