他汀类药物预防蛛网膜下腔出血患者迟发性脑血管痉挛的疗效

Effects of statins on the prevention of subarachnoid hemorrhage of patients with delayed cerebral vasospasm

目的探析他汀类药物预防蛛网膜下腔出血（SAH）患者迟发性脑血管痉挛（DCVS）的效果。方法选择广东省阳江市人民医院2013年5月~2014年5月收治的首次诊断为SAH患者40例,随机分为两组,各20例。所有患者均予以止血、脱水降颅压及尼莫地平静滴治疗,观察组口服辛伐他汀20 mg/d,治疗2周,对照组予以安慰剂,对比两组疗效。结果观察组DCVS发生率[5.0%（1/20）]显著低于对照组[35.0%（7/20）],治疗后大脑中动脉平均血流速度[（111.8±10.6）cm/s]显著低于对照组[（130.5±13.4）cm/s],差异均有统计学意义（P〈0.05、P〈0.01）;观察组并发症发生率[5.0%（1/20）]低于对照组[25.0%（5/20）],治疗后Hunt-Hess分级Ⅰ级患者较多,Ⅱ~Ⅳ级患者少于对照组,但差异无统计学意义（P〉0.05）。结论 SAH患者使用他汀类药物可发挥DCVS预防作用,改善脑血流速度和临床症状,降低并发症发生风险,提高预后。

Objective To explore and analyze the effects of statins on the prevention of subarachnoid hemorrhage（SAH）of patients with delayed cerebral vasospasm（DCVS）. Methods Forty cases of patients with first diagnosed SAH from May 2013 to May 2014 in Yangjiang People＇s Hospital were selected and divided into two groups of 20 cases randomly.All patients were given homeostasis, dehydration, intracranial pressure reduction, and intravenous nimodipine treatment.Observation group was treated with Simvastatin 20 mg/d for two weeks, while control group was treated with placebo.The effects of both groups were compared. Results DCVS rate of observation group [5.0%（1/20）] was significantly lower than the control group [35.0%（7/20）]. After treatment, VMCA [（111.8±10.6） cm/s] of observation group was significantly lower than the control group [（130.5±13.4） cm/s]. The differences were statistically significant（P〈0.05, P〈0.01）;complication rate of observation group [5.0%（1/20）] was lower than the control group [25.0%（5/20）]. After treatment,patients with Hunt-Hess Ⅰ level were more, patients with Ⅱ to Ⅳ level were less than control group, the differences were not statistically significant（P〈0.05）. Conclusion Statins are effective in the prevention of DCVS for patients with SAH, which can improve cerebral blood flow velocity and clinical symptoms, reduce the risk of complications, and improve prognosis.