他汀类药物与脑微出血相关性的Meta分析

Association between statins and cerebral microbleeds:A meta-analysis

目的 当前较公认的他汀类降脂药与自发性脑出血的风险增加有关,但它们与脑微出血(cerebral microbleed)的关系仍然存在争议。这篇Meta分析系统性评价了他汀类降脂药使用与脑微出血的关联性。方法 计算机检索中国知网(China national knowledge infrastructure, CNKI)、万方数据库(Wanfang data)、维普中文期刊服务平台(VIP data)、中国生物医学文献数据库(China biology medicine disc, CBM)、PubMed、荷兰医学文摘(the excerpta medica database, EMBASE)、循证医学图书馆(The Cochrane Library)、临床试验注册中心数据库,检索时限为2016年1月1日-2022年10月12日,收集他汀类降脂药与脑微出血的随机对照试验(randomized controlled trial, RCT)。应用Cochrane偏倚风险评估工具,采用Revman 5.3软件对纳入的研究进行方法学质量评价,采用Stata 15.0软件进行统计分析。结果 该研究共纳入7篇文献,包含656例患者。Meta分析结果显示,与对照组相比,加用阿托伐他汀钙辅助治疗后,脑微出血灶数目明显减少,甚至消失(OR=2.41,95%CI 1.78~3.25),且具有统计学意义。结论 现有结果显示,缺血性脑卒中并CMBs患者,在基础治疗基础上加用阿托伐他汀钙治疗,可下调患者血脂水平,明显减少脑微出血灶数目,减轻脑微出血程度。

Objective Currently recognized statins are associated with the increased risk of spontaneous intracerebral hemorrhage,but there are still controversies over their association with cerebral microbleeds(CMBs).This meta-analysis systematically evaluates the association between the use of statins and CMBs.Methods CNKI,Wanfang Data,VIP,CBM,PubMed,EMBASE,The Cochrane Library,and Clinical Trials databases were searched for randomized controlled trials(RCTs)of statins and CMBs published from January 1,2016 to October 12,2022.The Cochrane Collaboration′s tool for assessing risk of bias was used,Revman 5.3 software was used to assess the methodological quality of RCTs included in this study,and Stata 15.0 software was used for statistical analysis.Results A total of 7 articles involving 656 patients were included in this study.The meta-analysis showed that compared with the control group,there was a significant reduction in the number of CMBs or even disappearance of such lesions after adjuvant therapy with atorvastatin calcium adjuvant therapy(odds ratio=2.41,95%confidence interval:1.78-3.25).Conclusion Existing results show that for patients with ischemic stroke and CMBs,atorvastatin calcium in addition to basic treatment can downregulate blood lipid levels,significantly reduce the number of CMBs,and alleviate the degree of CMBs.