斯坦汀（Statins）不仅已被广泛应用于降低血清胆固醇，亦常被应用于预防缺血性中风（ischemic stroke）的患者再发中风。以往曾有报道认为，缺血性中风的患者接受斯坦汀治疗易并发脑出血，但日前加拿大学者报告的他们对近18，000名、年龄达到或大于66岁的缺血性中风患者为期12年研究的结果，却认为斯坦汀并不增加缺血性中风患者出现脑出血之风险。因此，研究人员认为广大医生应该遵循给缺血性中风之患者服用斯坦汀治疗之原则，以预防再发中风而有利于患者康复。

Statins Don't Raise Risk of Brain Bleeds After Stroke: Study

Guidelines call for them to prevent future strokes, but not all experts agree

By Mary Elizabeth Dallas

TUESDAY, Sept. 13 (HealthDay News) -- Statins, a widely prescribed class of drugs used to lower cholesterol, are not linked to an increased chance of brain bleeds in people who've had strokes, new research finds.

Statins are commonly prescribed to people who've had an ischemic stroke, caused by blocked blood flow to the brain, to reduce the risk of another stroke.

But two previous reviews raised concerns that statins might also raise the risk of bleeding in the brain.

"We found no evidence that such patients are at higher risk for cerebral bleeding than individuals who do not receive statins," the authors wrote. "Physicians should continue to adhere to current treatment guidelines recommending statin therapy for most patients with a history of ischemic stroke."

The study is published online in the Sept. 12 issue of the Archives of Neurology

Researchers in Canada analyzed data on nearly 18,000 patients aged 66 and older who suffered an ischemic stroke over the course of 12 years. Half of the patients received statins after their stroke; half did not.

Some 213 people experienced bleeding in the brain during an average follow-up of more than four years.

The rate of brain bleeds was slightly lower in patients on statins, although it wasn't a statistically significant difference, the authors said in a journal news release.

In an accompanying editorial, Dr. Philip B. Gorelick of the University of Illinois College of Medicine, Chicago, said more research is needed to make a final determination about the safety and utility of statins in stroke patients.

To prevent future strokes, stroke patients should also keep their blood pressure in check, Gorelick added.

"The clinical decision to administer a statin following ICH [intercerebral hemorrhage, or brain bleed] remains a challenging one with available evidence tilting in the direction of withholding such therapy, especially when there is a history of lobar brain hemorrhage," Gorelick wrote in the news release.

Patients and families should be informed of the risks and participate in the decision whether to take statins, he added.

SOURCE: JAMA/Archives, news release, Sept. 12, 2011