阿托伐他汀联合钻孔引流术治疗慢性硬膜下血肿的疗效及对血清NSE、VEGF及HPA的研究

Efficacy of atorvastatin combined with trepanation and drainage in the treatment of chronic subdural hematoma and its effects on serum NSE,VEGF and HPA

目的观察阿托伐他汀(Ato)联合钻孔引流术治疗慢性硬膜下血肿(CSH)的疗效及对血清神经元特异性烯醇化酶(NSE)、血管内皮生长因子(VEGF)及乙酰肝素酶(HPA)的影响。方法按随机数表法将2017年3月至2019年3月我院84例CSH患者分为Ato+钻孔引流术组(联合组,n=42)和钻孔引流术组(对照组,n=42)。治疗2个月后评估疗效;于治疗前及治疗2个月后检测患者血清学相关指标水平,评估患者神经功能和日常活动能力,观察并发症和复发情况。结果联合组总有效率大于对照组(P<0.05)。治疗2个月后,两组血清NSE、VEGF、HPA水平及CSS评分均较治疗前降低,且联合组低于对照组(P<0.05);MBI评分均较治疗前升高,且联合组高于对照组(P<0.05)。联合组复发率低于对照组(P<0.05)。结论Ato联合钻孔引流术治疗CSH有助于进一步提升疗效,下调血清NSE、VEGF、HPA水平,改善患者神经功能和日常活动能力,降低复发率,且安全性良好。

Objective To observe the efficacy of atorvastatin(Ato)combined with drilling drainage in the treatment of chronic subdural hematoma(CSH)and its effects on serum neuron-specific enolase(NSE),vascular endothelial growth factor(VEGF)and heparanase(HPA).Methods According to the random number table method,84patients with CSH from March 2017 to March 2019were divided into Ato+trepanation and drainage group(combined group,n=42)and trepanation and drainage group(control group,n=42).The efficacy was evaluated after 2 months of treatment.The serum related indicators levels were measured before treatment and af-ter 2months of treatment,and the neurological function and daily activity ability were evaluated.The complications and recurrence were observed.Results The total effective rate in combined group was higher than that in control group(P<0.05).After 2months of treatment,the levels of serum NSE,VEGF and HPA and CSS score in the two groups were lower than those before treat-ment,and the levels and score in combined group were lower than those in control group(P<0.05).The MBI score was higher than that before treatment,and the score in combined group was higher than that in control group(P<0.05).The recurrence rate in combined group was lower than that in control group(P<0.05).Conclusion Ato combined with trepanation and drainage for CSH can further improve the efficacy,down-regulate levels of serum NSE,VEGF and HPA,improve neurological function and daily activity ability,and reduce recurrence rate,and it has good safety.