| 孙一彤
，任思颖
，王丽琨
，宋安军
，毛远红
，秦冠南
，胡晓纯
，李颖慧
，李琦
，伍国锋.阿托伐他汀治疗改善脑出血患者近期神经功能的临床研究[J].神经损伤功能重建,2022,17(9):502-508 |
| 阿托伐他汀治疗改善脑出血患者近期神经功能的临床研究 |
| Atorvastatin Improves Recent Neurological Function in Patients with IntracerebralHemorrhage |
| |
| DOI： |
| 中文关键词: 脑出血 阿托伐他汀 改良Rankin量表评分 神经功能 脑出血预后 |
| 英文关键词: intracerebral hemorrhage Atorvastatin modified Rankin scale score neurological function prognosis of intracerebral hemorrhage |
| 基金项目:国家自然科学基金
（No. 81971126/H0
906） |
|
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| 中文摘要: |
| 目的：探索阿托伐他汀治疗脑出血能否改善患者发病后3月的临床预后。 方法：纳入选择保守治疗
的自发性脑出血患者131例，随机分为对照组84例和他汀组47例。2组均按中国脑出血指南进行治疗，其
中他汀组于入院后24 h内开始予以阿托伐他汀钙片20 mg，此后按照20 mg/d的剂量继续服用90 d；随访主
要结果指标是随机化后90 d改良Rankin量表（mRS）评分的序贯分析及不良结局的患者比例，不良结局定
义为死亡（mRS评分=6分）或重大残疾（mRS评分3～5分）。mRS≤2分认为临床结局良好。次要结局指
标是治疗后患者血肿体积的影像学变化。 结果：他汀组治疗有效且结局良好31例（65.96%）；对照组结局
良好31例（36.90%），二者有显著性差异（P=0.001）。随访观察对照组死亡27例（32.14%），他汀组死亡6例 （12.77%），差异有统计学意义（P=0.014）。至随访结束他汀组、对照组不良反应发生情况相似，没有因他汀
类药物的不良反应而需停药者，且他汀组再次发生脑出血的风险无明显增加。结论：选择保守治疗的脑出
血患者于入院后24 h内予以阿托伐他汀治疗可改善3月时患者预后情况，同时未见明显不良反应。 |
| 英文摘要: |
| To explore whether Atorvastatin treatment of intracerebral hemorrhage can improve the
clinical prognosis of patients 3 months after onset. Methods: A total of 131 patients with spontaneous
intracerebral hemorrhage who underwent conservative treatment were enrolled in the study. They were
randomized into the control group (n=84) and the Statin group (n=47). Both groups of patients were treated
according to the Chinese intracerebral hemorrhage guidelines. The Statin group began taking 20 mg
Atorvastatin calcium tablets within 24 hours of admission. The Atorvastatin was continued for 90 days at a dose
of 20 mg/day. The primary outcome measures were the sequential analysis of the 90-day Modified Rankin Scale
(mRS) score after randomization and the proportion of patients with adverse outcomes. Adverse outcomes were
defined as death (mRS score=6 points) or major disability (mRS score=3～5 points); mRS score≤2 points was
considered good clinical outcome. The secondary outcome measure was the imaging change of hematoma
volume in patients after treatment. Results: In the Statin group, 31 patients (65.96% ) had good outcomes,
while in the control group, 31 patients (36.90% ) had good outcomes, and this difference was statistically
significant (P=0.001). Follow-up observation showed that 27 patients (32.14%) died in the control group and 6
patients (12.77% ) in the Statin group; the difference was statistically significant (P=0.014). By the end of
follow-up, the adverse reactions of the Statin group and the control group were similar. No patient needed to
stop drug use due to adverse reactions of Statins, and there was no significant increase in the risk of recurrent
intracerebral hemorrhage in the Statin group. Conclusion: Patients with intracerebral hemorrhage who were
conservatively treated with Atorvastatin within 24 hours of admission improved their prognosis at 3 months and
showed no significant adverse effects. |
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