| ObjectiveTo observe the clinical efficacy,neurological function assessment results,serum hs-CRP levels,serum IL-6 levels,serum MMP-9 levels,serum TNF-α levels and changes in hematoma volume during treatment of chronic subdural hematomas with atorvastatin.At the same time,to pay attention to the adverse reactions and recurrence rates of patients,to detect the overall clinical efficacy and safety of atorvastatin in the treatment of chronic subdural hematoma,so as to provide new ideas for the treatment of chronic subdural hematoma.MethodsIn this study,58 patients with CSDH admitted to Taishan Central Hospital from October 2017 to December 2018 were selected as the study subjects.After the subgroup was determined,28 patients in each of the control group and atorvastatin treatment group were effective.The age and sex distribution of the patients in the control group and atorvastatin treatment group were statistically analyzed,and the basic conditions such as the first symptom of admission and the neurological function score were recorded and recorded.The control group was given conventional nutritional neuropharmaceutical treatment,and atorvastatin treatment group was given atorvastatin for a prescribed course of treatment.After 24 weeks of treatment,a simple comparison was made between the clinical efficacy of the atorvastatin treatment group and the control group.After 4 weeks,8 weeks,12 weeks and 24 weeks of treatment,the ADL scores and CSS scores of patients with chronic subdural hematoma in atorvastatin treatment group and control group were statistically analyzed.By comparing the self-care ability and neurological status assessment of the two groups of patients,the neurological status of the two groups of patients with chronic subdural hematoma was compared.Results1.Compared with before treatment,atorvastatin treatment group recovered significantly effective and effective number of patients reached 15,6,4 respectively,the total effective rate reached 89.29%.The number of cured,effective,and effective patients in the control group was 8,6,and 5,respectively,and 9 patients were ineffective in treatment.The total effective rate was only 67.86%.During the entire course of treatment,the total effective rates of atorvastatin treatment group and control group were significantly different(P=0.024).2.The ADL scores of CSDH patients in the atorvastatin treatment group were(70.4±5.20)at admission,and the ADL scores of CSDH patients at the time of admission were(71.2±5.18)in the control group,and there was no significant statistical difference(P=0.678).After basic care and basic brain cell therapy,the ADL score was(98.3±9.64)at the end of treatment in CSDH patients in the atorvastatin treatment group,and the ADL score in the control group was reached at the end of treatment(83.8 ± 6.85).There was a statistically significant difference in the ADL scores between the two groups(P=0.013).Similarly,CSS scores for CSDH patients at the time of admission in the atorvastatin treatment group were(24.3±5.01),and CSS scores for the control group at admission were(28.9±5.43),with no statistically significant difference(P=0.873).At the end of treatment,the CSS score of CSDH patients in the atorvastatin treatment group was(13.8±3.89),and the CSS score in the control group CSDH patients was(20.1 ±4.67).There was a statistically significant difference in CSS scores between the two groups(P=0.021).3.After 24 weeks of treatment,the serum hs-CRP level in the atorvastatin treatment group was(3.5±0.18)mg/L,which was decreased by 45.31%(6.4±0.41)mg/L on the admission examination.The serum hs-CRP level in patients with CSDH in the control group was(4.8±0.23)mg/L,which was decreased by 25.00%on the admission examination((6.4±0.38)mg/L).After 24 weeks of treatment,the inflammation of CSDH patients in the atorvastatin treatment group was better controlled and the two were statistically significant(P=0.000).After 24 weeks of treatment,the serum IL-6 level in patients with atorvastatin treatment group was(19.0±4.57)mg/L,and was decreased by 29.89%on the basis of examination at admission((27.1 ± 10.02)mg/L)..The level of serum IL-6 in patients with CSDH in the control group was(21.9±6.34)mg/L,and was decreased by 19.19%on the basis of examination at admission((27.1 ±9.89)mg/L).After 24 weeks of treatment,compared with the control group,serum levels of IL-6 in patients with CSDH were lower,which was statistically significant(P<0.05).After 24 weeks of treatment,the serum level of MMP-9 in CSDH patients treated with atorvastatin was(341.9±8.66)μg/L,which was decreased by 49.08%on the admission examination((671.5±21.68)μtg/L).The serum level of MMP-9 in patients with CSDH in the control group was(410.4± 12.54)μg/L,which was decreased by 38.81%on the basis of examination at admission((670.3±20.89)μg/L).After 24 weeks of treatment,compared with the control group,the level of serum MMP-9 in patients with CSDH was lower,and there was a statistically significant difference between the two groups(P<0.05).After 24 weeks of treatment,serum TNF-α levels in CSDH patients treated with atorvastatin were(28.2±2.89)μg/L,which was decreased by 36.05%(44.1 ± 10.12)μg/L on the admission examination.The level of serum TNF-α in patients with CSDH in the control group was(34.9±6.78)μg/L,which was decreased by 20.68%(44.0±10.35)μg/L on the admission examination.At the 24th week of treatment,compared with the control group,the level of serum TNF-α in patients with CSDH was lower,and there was a statistically significant difference between the two groups(P<0.05).4.Before treatment,the hematoma volume of CSDH patients in the atorvastatin treatment group and the control group were(20.1 ±4.13)mL and(19.9±4.42)mL,respectively,and there was no statistical difference(two independent samples T test,t=0.339,P=0.736,no statistical difference).At the 24th week of treatment,the hematoma volume of CSDH patients in the atorvastatin treatment group was significantly higher than that in the control group,and the hematoma volume was significantly lower than that in the control group(P=0.008).5.The main adverse reactions of the two groups of patients with CSDH were nausea and vomiting,abdominal discomfort,mildly elevated transaminases,dyslipidemia and rash.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The recurrence rate of the control group(3.60%)was significantly higher than that of the control group(25.00%),and the difference was statistically significant(P<0.05).ConclusionWhen atorvastat is used to treat chronic subdural hematoma,it can reduce the inflammatory damage in the patient,reduce the amount of hematoma,protect the patient’s neurological function,reduce the recurrence rate of the patient,and thus improve the curative effect of chronic subdural hematoma.Although there was no statistically significant difference in the adverse reactions between the two groups in the study,atorvastatin treatment can reduce the recurrence rate. |
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