Statin treatment reduces the risk of poststroke seizures
Statin treatment reduces the risk of poststroke seizures
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他汀类药物治疗可降低中风后癫痫发作的风险
DOI：
10.1212/wnl.0000000000001814
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发表时间：
2015-08-25
期刊：
影响因子：
9.9
通讯作者：
Zhou, Dong
中科院分区：
文献类型：
--
作者：
Guo, Jiang;Guo, Jian;Zhou, Dong
目的：探讨他汀类药物治疗在降低卒中后癫痫发作风险方面的潜在疗效。方法：在这项队列研究中，入选了首次缺血性卒中且卒中前无癫痫病史的患者。在平均2.5年的随访期后，进行随访评估以识别卒中后癫痫。Logistic回归和考克斯回归分析用于评估他汀类药物使用与卒中后早发性癫痫发作或卒中后癫痫之间的关系。结果：在1,832例入选患者中，63例（3.4%）患者有脑卒中后早发性癫痫发作，91例（5.0%）患者有脑卒中后癫痫。他汀类药物的使用与卒中后早发性癫痫发作的风险降低相关（比值比[OR] 0.35，95%可信区间[CI] 0.20-0.60，p < 0.001），这种风险降低主要见于仅在急性期使用他汀类药物的患者（OR 0.36，95% CI 0.20-0.62，p < 0.001）。他汀类药物使用与卒中后癫痫之间无显著相关性（OR 0.81，95%CI 0.52-1.26，p = 0.349）。在63例早发性癫痫患者中，他汀类药物的使用与卒中后癫痫风险降低相关（OR 0.34，95%CI 0.13-0.88，p = 0.026）。结论：他汀类药物的使用，特别是在急性期，可能会降低卒中后早发性癫痫发作的风险。此外，他汀类药物治疗可能会阻止最初的卒中后癫痫诱导的神经变性进展为慢性癫痫。由于这项研究的观察性质，需要更多的研究来证实结果。证据分类：这项研究提供了III类证据，表明在首次缺血性卒中患者中，早期使用他汀类药物可降低卒中后早期癫痫发作的风险。
Objective: To examine the potential efficacy of statin treatment in reducing the risk of poststroke seizures. Methods: In this cohort study, patients with a first-ever ischemic stroke and no history of epilepsy before stroke were enrolled. After a mean follow-up period of 2.5 years, a follow-up assessment was performed to identify poststroke epilepsy. Logistic regression and Cox regression analyses were used to assess the relationship between statin use and poststroke early-onset seizures or poststroke epilepsy. Results: Of 1,832 enrolled patients, 63 (3.4%) patients had poststroke early-onset seizures and 91 (5.0%) patients had poststroke epilepsy. Statin use was associated with a lower risk of poststroke early-onset seizures (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.20–0.60, p < 0.001), and this reduced risk was seen mainly in patients who used a statin only in the acute phase (OR 0.36, 95% CI 0.20–0.62, p < 0.001). No significant association was found between statin use and poststroke epilepsy (OR 0.81, 95% CI 0.52–1.26, p = 0.349). In 63 patients who presented with early-onset seizures, statin use was associated with reduced risk of poststroke epilepsy (OR 0.34, 95% CI 0.13–0.88, p = 0.026). Conclusions: Statin use, especially in the acute phase, may reduce the risk of poststroke early-onset seizures. In addition, statin treatment may prevent the progression of initial poststroke seizure-induced neurodegeneration into chronic epilepsy. Because of the observational nature of the study, more studies are needed to confirm the results. Classification of evidence: This study provides Class III evidence that in patients with a first-ever ischemic stroke, the early use of statins reduces the risk of early poststroke seizures.