[Effects of statins on mortality and neurologic outcomes in patients with traumatic brain injury: a meta-analysis].

Objective: To systematically evaluate the effects of statins on the mortality and neurologic function prognosis in patients with traumatic brain injury (TBI). Methods: The PubMed, Embase, the Cochrane Library, the Cochrane Clinical Controlled Trial Center Registry Database, Chinese Journal Full-text Database (CNKI), and WanFang database up to 2021.1 were searched to obtain clinical randomized controlled trials (RCTs) and retrospective cohort studies of statins in the treatment of TBI. Inclusion and exclusion criteria were used to screen literature and extract data. Ottawa scale and the RCT bias risk assessment tool was used for quality evaluation. Comprehensive Meta Analysis V3 statistical software for meta-analysis was applied. Results: Thirteen studies were included, with a total of 116, 500 patients, including 46, 933 patients using statins in the intervention group and 69, 567 patients in the control group. Meta-analysis results showed that compared with the control group, statins can reduce the mortality of TBI patients (OR=0.82, 95%CI: 0.74-0.92, P<0.01), significantly improve the neurologic outcomes of TBI patients (OR=0.19, 95%CI: 0.13-0.26, P<0.01), and reduce the levels of TNF-α and IL-1β after TBI (TNF-α: OR=0.16, 95%CI: 0.07-0.34, P<0.01; IL-1β: OR=0.08, 95%CI: 0.04-0.18, P<0.01), with statistically significant differences. Conclusion: Statins can reduce the mortality of patients with TBI and improve the neurologic outcomes. Their reduction of inflammation in the body may be the basis of potential treatment, but more high-quality RCTs are still warranted.目的： 系统评价他汀类药物对创伤性颅脑损伤（TBI）患者病死率及神经系统功能预后的影响。 方法： 检索PubMed数据库、Embase数据库、Cochrane图书馆、Cochrane临床对照试验中心注册数据库、中国期刊全文数据库（CNKI）、万方数据库至2021年1月，获取他汀类药物治疗创伤性颅脑损伤的临床随机对照研究及队列研究，按照纳入和排除标准筛选文献，进行资料提取，采用Cochrane手册推荐的RCT偏倚风险评价工具及渥太华量表进行质量评价，应用Comprehensive Meta Analysis V3统计软件进行荟萃分析。 结果： 纳入13篇研究，共计116 500例患者，其中应用他汀类药物（干预组）46 933例患者，对照组69 567例患者。荟萃分析结果显示，与对照组相比，他汀类药物可降低TBI患者的病死率（OR=0.82，95%CI：0.74~0.92，P<0.01），可明显改善TBI患者神经系统功能预后（OR=0.19，95%CI：0.13~0.26，P<0.01），可降低TBI后炎性指标TNF-α、IL-1β的水平（TNF-α：OR=0.16，95%CI：0.07~0.34，P<0.01；IL-1β：OR=0.08，95%CI：0.04~0.18，P<0.01），差异均有统计学意义。 结论： 他汀类药物可降低TBI患者的病死率，并改善其神经系统功能预后，其降低体内炎症水平可能是潜在的治疗基础，但仍需更多的高质量随机对照研究加以证实。.