洛伐他汀对颅脑损伤术后颅内感染并发癫痫的作用

Effects of Lovastatin on Intracranial Infection and Epilepsy after Craniocerebral Injury

目的探讨洛伐他汀对颅脑损伤术后颅内感染并发癫痫的预防作用及对脑脊液TNF-α和IL-10水平的影响,分析其预防癫痫的可能机制。方法将2015年6月-2017年6月某院收治的颅脑外伤术后颅内感染的患者随机分为观察组和对照组各80例,对照组常规给予腰大池灌洗引流及对症治疗,观察组加用洛伐他汀口服。观察并记录患者引流及感染控制时间,癫痫发作情况,引流前后脑脊液TNF-α、IL-10水平以及临床预后情况。结果观察组患者癫痫发作率明显低于对照组,差异有统计学意义(P<0.05)。引流结束时,两组患者脑脊液TNF-α、IL-10水平均明显低于引流前,且TNF-α降低更为显著,组间比较,观察组TNF-α水平更低,IL-10水平更高,而癫痫组二者水平均明显高于非癫痫组,差异均有统计学意义(P<0.05)。出院后3个月,观察组GOS平均分明显高于对照组,且癫痫组明显低于非癫痫组,差异有统计学意义(P<0.05)。结论洛伐他汀对颅内感染患者癫痫发作具有一定的预防作用,其机制可能与洛伐他汀降低颅内病变炎症及氧化应激反应,从而改善颅内感染所致神经元兴奋性增强作用有关。

Objectives To investigate the preventive effect of lovastatin on intracranial infection complicated with epilepsy after craniocerebral injury and its effect on TNF-α and IL-10 levels of cerebrospinal fluid,and analyze the possible mechanism of preventing epilepsy. Methods From June 2015 to June 2017 of craniocerebral trauma admitted in a hospital of postoperative intracranial infection patients were randomly divided into observation group and control group 80 cases,control group of conventional waist big pool lavage drainage and symptomatic treatment,observation group with lovastatin oral. The patients＇ drainage and infection control time,seizures,tnf-10 level of cerebrospinal fluid and its clinical prognosis were observed and recorded. Results The seizure rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant（P〈0.05）. Drainage at the end,the two groups of patients with CSF TNF-α and IL-10 levels were significantly lower than before the drainage,and TNF-α reduced more significantly,comparison between groups,the observation group of TNF-α level was lower and higher levels of IL-10,the two levels and epilepsy group were obviously higher than that of non-epilepsy group,differences were statistically significant（P〈0.05）. 3 months after discharge,GOS score of the observation group was significantly higher than that of the control group,and that of the epileptic group was significantly lower than that of the non-epileptic group,with statistically significant difference（P〈0.05）.Conclusions Lovastatin epileptic seizures in patients with intracranial infection had certain preventive effect,its mechanism may be related to lovastatin reduce inflammation and oxidative stress reaction of intracranial lesions,thus improve the intracranial infection caused by neuronal excitability enhancement effect.