the biochemical basis of hydroxymethylglutaryl-coa reductase inhibitors as neuroprotective agents in aneurysmal subarachnoid hemorrhage的生化基础hydroxymethylglutaryl-coa还原酶抑制剂作为神经保护制剂在动脉瘤性蛛网膜下腔出血.pdf

Pharmaceuticals 2010, 3, 3186-3199; doi:10.3390/ph3103186 OPEN ACCESS Pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review The Biochemical Basis of Hydroxymethylglutaryl-CoA Reductase Inhibitors as Neuroprotective Agents in Aneurysmal Subarachnoid Hemorrhage George Kwok Chu Wong * and Wai Sang Poon Department of Surgery, Prince of Wales Hospital, Shatin, NT, Hong Kong, China; E-Mail: wpoon@.hk (W.S.P.) * Author to whom correspondence should be addressed; E-Mail: georgewong@.hk; Tel.: +852-2632-2624; Fax: +857-2637-7974. Received: 30 August 2010; in revised form: 29 September 2010 / Accepted: 11 October 2010 / Published: 12 October 2010 Abstract: Aneurysmal subarachnoid hemorrhage (SAH) has the highest morbidity and mortality rates of all types of stroke. Many aneurysmal SAH patients continue to suffer from significant neurological morbidity and mortality directly related to delayed cerebral ischemia. Pilot clinical studies of the use of Hydroxymethylglutaryl-CoA Reductase Inhibitors (statins) in aneurysmal SAH patients have reported a reduction in delayed cerebral ischemia and better clinical outcomes. We review the biochemical effects of statins on endothelium vascular function, glutamate-mediated neurotoxicity, inflammatory changes, and oxidative injuries, with reference to their possible neuroprotective effects in aneurysmal SAH. Keywords: aneurysm; hydroxymethylglutaryl-CoA reductase inhibitors; neuroprotective agent; suba