四川大学华西医院研究者们近期发表于《神经病学》(Neurology)杂志的一项观察性研究表明，他汀可减少卒中后早发型癫痫风险，尤其是在急性期;另外，他汀还可能预防卒中后癫痫诱发的神经功能恶化进展为慢性癫痫。

        该队列研究纳入了无癫痫病史的首次缺血性卒中患者，对其平均随访2.5年，评估卒中后癫痫。利用逻辑回归和Cox回归分析法评估他汀类药物应用于卒中后早发型癫痫或卒中后癫痫的相关性。

        结果显示，在纳入的1832例患者中，卒中后早发型癫痫和卒中后癫痫患者分别为63例(3.4%)和91例 (5.0%)。他汀类药物的应用与卒中后早期癫痫风险较低有关[比值比(OR)0.35，95%置信区间(CI)0.20–0.60，P< 0.001]，上述风险减少主要见于那些仅在急性期应用他汀类药物的患者(OR 0.36，95% CI 0.20–0.62，P< 0.001)。他汀类药物的应用与卒中后癫痫无显著相关性(OR 0.81, 95% CI 0.52–1.26，P= 0.349)。在63例出现早发型癫痫的患者中，他汀类药物的应用于卒中后癫痫风险减少有关(OR 0.34, 95% CI 0.13–0.88，P = 0.026)。

        参考文献：Jiang Guo,et al. Neurology.published ahead of printJuly 22, 20151526-632X

Statin treatment reduces the risk of poststroke seizures
1. Jiang Guo, MD*,
2. Jian Guo, MD*,
3. Jinmei Li, MD,
4. Muke Zhou, MD,
5. Fengqin Qin, MD,
6. Shihong Zhang, MD,
7. Bo Wu, MD,
8. Li He, MDand
9. Dong Zhou, MD
1. From the Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.
1. Correspondence to Dr. Zhou: zhoudong66{at}yahoo.de or Dr. He: heli2003new{at}126.com
ABSTRACT
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 63patients 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.