%0杂志文章%A Boe, Nils Jensen %A Hald, Stine Munk %A Jensen, Mie Micheelsen %A Bojsen, Jonas Asgaard %A Elhakim, Mohammad Talal %A Florisson, Sandra %A Saleh, Alisa %A Clausen, Anne %A Möller, Sören %A Harbo, Frederik Severin Gråe %A Graumann, Ole %A Hallas, Jesper %A García Rodríguez, Luis Alberto %A Al-Shahi Salman, Rustam %A Goldstein, Larry B. %A Gaist，他汀类药物使用与脑出血位置的关系A嵌套病例对照研究%D 2023 %R 10.1212/WNL。背景与目的他汀类药物使用与脑出血(ICH首页)之间的因果关系尚不确定。我们假设长期他汀类药物暴露与ICH风险之间的关联可能因不同的ICH位置而有所不同。方法:我们使用丹麦全国范围内的相关登记进行了分析。在丹麦南部地区(人口120万)，我们确定了2009年至2018年间年龄≥55岁的所有首次脑出血病例。经医疗记录证实诊断的患者被分为大叶性脑出血或非大叶性脑出血，并在年龄、性别和日历年方面与一般人群对照相匹配。我们使用全国处方注册表来确定之前使用他汀类药物和其他药物，并根据最近时间、持续时间和强度进行分类。使用对潜在混杂因素进行调整的条件logistic回归，我们计算了大叶性和非大叶性脑出血风险的调整ORs (aORs)和相应的95% ci。结果:我们确定了989例大叶性脑出血患者(52.2%为女性，平均年龄76.3岁)与39500名对照者匹配，1175例非大叶性脑出血患者(46.5%为女性，平均年龄75.1岁)与46755名对照者匹配。目前使用他汀类药物与大叶病变风险降低相关(aOR 0.83; 95% CI, 0.70–0.98) and nonlobar ICH (aOR 0.84; 95% CI, 0.72–0.98). Longer duration of statin use was also associated with a lower risk of lobar (<1 year: aOR 0.89; 95% CI, 0.69–1.14; ≥1 year to <5 years aOR 0.89; 95% CI 0.73–1.09; ≥5 years aOR 0.67; 95% CI, 0.51–0.87; p for trend 0.040) and nonlobar ICH (<1 year: aOR 1.00; 95% CI, 0.80–1.25; ≥1 year to <5 years aOR 0.88; 95% CI 0.73–1.06; ≥5 years aOR 0.62; 95% CI, 0.48–0.80; p for trend <0.001). Estimates stratified by statin intensity were similar to the main estimates for low-medium intensity therapy (lobar aOR 0.82; nonlobar aOR 0.84); the association with high-intensity therapy was neutral.Discussion We found that statin use was associated with a lower risk of ICH, particularly with longer treatment duration. This association did not vary by hematoma location.aOR=adjusted OR; CAA=cerebral amyloid angiopathy; ICH=intracerebral hemorrhage; IVH=intraventricular hemorrhage; RSD=Region of Southern Denmark; SVD=small vessel disease %U //www.ez-admanager.com/content/neurology/100/10/e1048.full.pdf

map