不同剂量阿托伐他汀对慢性硬膜下血肿的疗效及安全性评价

摘要

目的：观察不同剂量的阿托伐他汀对慢性硬膜下血肿（CSDH）患者的临床疗效和安全性。方法：选择2013年6月－2015年5月我院CSDH患者128例，按照随机数字表法分为观察组（n＝62）和对照组（n＝66）。所有患者均给予常规的脑细胞营养治疗；对照组患者给予阿托伐他汀钙片20 mg，po，qd；观察组患者给予阿托伐他汀钙片40 mg，po，qd。两组患者均连续治疗6个月。观察两组患者的临床疗效、神经功能缺损评分标准（CSS）及日常生活能力量表（ADL）评分、血肿量和血清炎症因子[超敏C反应蛋白（hs-CRP）、基质金属蛋白酶9（MMP-9）、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）]水平，记录治疗过程中的不良反应及治疗后6个月内的复发率。结果：观察组患者脱落2例，对照组患者脱落6例，最终纳入统计的合格病例为120例，两组各60例。观察组患者总有效率（88.3％）明显优于对照组（73.3％），差异有统计学意义（P＜0.05）。治疗后1、3、6个月，两组患者CSS评分、血肿量和血清hs-CRP、MMP-9、IL-6、TNF-α水平明显降低，ADL评分明显升高，且观察组患者上述指标改善程度明显优于对照组，差异均有统计学意义（P＜0.05）。两组患者各项不良反应的发生率比较，差异均无统计学意义（P＞0.05）。对照组患者的复发率（13.3％）明显高于观察组（3.3％），差异有统计学意义（P＜0.05）。结论：阿托伐他汀40 mg的日剂量对CSDH患者的临床疗效更好、复发率更低，且安全性良好。%OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.