立体定向血肿抽吸术联合阿托伐他汀对脑出血患者血清神经元特异性烯醇化酶、S100B蛋白水平及预后的影响

Effects of Stereotactic hematoma Aspiration Combined with Atorvastatin on Serum NSE and S100B Protein Levels and Prognosis in Patients with Spontaneous Cerebral Hemorrhage

目的:观察立体定向血肿抽吸术联合阿托伐他汀治疗对脑出血患者血清神经元特异性烯醇化酶(NSE)、S100B蛋白水平及预后的影响。方法:回顾分析基底节区出血(出血量30~40 ml)患者60例,随机分为对照组和观察组,每组各30例,对照组早期接受立体定向血肿抽吸术及常规内科治疗,观察组除接受相同手术及内科治疗外,早期口服或鼻饲阿托伐他汀治疗20 mg/次,1次/d,持续28 d。比较两组手术前及手术后第3天、第7天、第14天血清NSE、S100B蛋白水平。采用美国国立卫生研究院卒中量表(NIHSS)评估两组治疗后第14天和第30天的神经功能,使用改良Rankin量(mRS)表评价手术后90 d预后情况。结果:手术后各时间点观察组血清NSE、S100B蛋白水平均明显低于对照组,差异有统计学意义(P<0.01),但两组手术后第14天、第30天NIHSS评分比较,差异无统计学意义(P>0.05),随访手术后90 d观察组mRS评分低于对照组,差异有统计学意义(P<0.05)。结论:立体定向血肿抽吸术联合阿托伐他汀治疗可以降低中等量脑出血患者血清NSE、S100B蛋白水平,减轻继发性脑损伤,患者有更好的远期神经功能预后。

Objective To observe the effect of stereotactic hematoma aspiration combined with atorvastatin on serum levels of neuron specific enolase(NSE),S100B protein and prognosis in patients with spontaneous cerebral hemorrhage.Method Retrospective analysis of 60 patients with spontaneous basal ganglia hemorrhage 30~40 ml.randomly divided into control group and observation group,30 cases in each group.The control group received stereotactic hematoma aspiration and conventional medical treatment.The observation group received oral or gastric tube administration of atorvastatin(20 mg once a day for 28 days)except for the same surgery and medical treatment.The levels of serum NSE and S100B protein were compared between the groups before operation and on the 3rd,7th and 14th day after operation.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the neurological status of the two groups at 14 and 30 days after treatment,and the modified Rankin scale(mRS)was used to evaluate the prognosis at 90 days after treatment.Results The levels of serum NSE and S100B protein in the observation group were significantly lower than those in the control group at each time point after operation(P<0.01),but the NIHSS scores at 14 and 30 days after treatment were not statistically significant(P>0.05).The mRS scores of the observation group were lower than those of the control group at 90 days after follow-up,and the difference was statistically significant(P<0.05).Conclusion Stereotactic hematoma aspiration combined with conventional dosage of atorvastatin can reduce the levels of serum NSE and S100B protein in patients with moderate basal ganglia hemorrhage,alleviate secondary brain injury,and have better long-term functional prognosis.