ApoE基因分型对阿托伐他汀钙片辅助钻孔引流治疗慢性硬膜下血肿疗效的影响  

Effect of ApoE genotype on efficacy of atorvastatin calcium tablets assisting drilling drainage surgery in treatment of chronic subdural hematoma

作　　者：乔木 孙帆 罗宽 QIAO Mu;SUN Fan;LUO Kuan(Neurosurgery Department,Wuhan Puren Hospital,Wuhan 430080,China)

机构地区：[1]武汉市普仁医院神经外科,武汉430080

出　　处：《山东医药》2023年第31期15-18,共4页Shandong Medical Journal

基　　金：武汉市卫生健康科研基金项目(WX20D82)。

摘　　要：目的探讨ApoE基因分型对阿托伐他汀钙片辅助钻孔引流术治疗慢性硬膜下血肿疗效的影响。方法选取慢性硬膜下血肿患者70例,均行钻孔引流术,用连接测序法检测ApoE基因型,根据检测结果将患者分为敏感组50例、非敏感组20例。于术后当天开始予阿托伐他汀钙片20 mg,每晚21:00口服,连续服药45 d后复查头颅CT。对比两组手术相关指标(残余血肿量、硬膜下积液量、颅内积气、复发、症状消失时间等),两组治疗前(入院当天)、治疗后(服药45 d)Karnofsky功能状态(KPS)评分、日常生活活动能力量表(ADL)评分、中国卒中量表(CSS)评分。结果敏感组颅内积气16例,复发8例,残余血肿量(6.52±2.03)mL,硬膜下积液量(7.78±3.67)mL,症状消失时间(15.05±2.30)d;非敏感组颅内积气10例,复发8例,残余血肿量(8.95±2.44)mL,硬膜下积液量(11.20±6.95)mL,症状消失时间(21.45±3.05)d。敏感组残余血肿量、硬膜下积液量、症状消失时间、复发率与非敏感组比较差异均有统计学意义(P均<0.05),两组颅内积气发生率比较差异无统计学意义(P>0.05)。治疗后,两组KPS、ADL评分较治疗前升高,CSS评分较治疗前降低(P均<0.05);且敏感组KPS、ADL评分高于非敏感组,CSS评分低于非敏感组(P均<0.05)。结论ApoE2、ApoE3基因型慢性硬膜下血肿患者钻孔引流术后应用阿托伐他汀钙片的疗效优于AopE4基因型患者。Objective To investigate the effect of ApoE genotype on the efficacy of chronic subdural hematoma treated with atorvastatin calcium tablets-assisted drilling drainage surgery.Methods Seventy patients with chronic subdural hematoma were selected,and the ApoE genotypes were detected by ligase sequencing method.According to the detection results,the patients were divided into the sensitive group(50 cases)and non-sensitive group(20 cases).All patients underwent drilling drainage surgery,and atorvastatin calcium tablets 20 mg were taken orally at 21:00 every night on the day after surgery.After 45 days of continuous medication,head CT was reexamined.The postoperative indicators(residual hematoma,subdural effusion,intracranial air accumulation,recurrence,symptom disappearance time,etc.),Karnofsky functional status(KPS)score,Activity of Daily Living Scale(ADL)score and Chinese Stroke Scale(CSS)score were compared between the two groups before treatment(the day of admission)and after treatment(45 days after taking medication).Results In the sensitive group,there were 16 cases of intracranial air accumulation and 8 cases of recurrence;the residual hematoma volume was(6.52±2.03)mL,subdural effusion volume was(7.78±3.67)mL,and the symptom resolution time was(15.05±2.30)d.In the non-sensitive group,there were 10 cases of intracranial air accumulation and 8 cases of recurrence;the residual hematoma volume was(8.95±2.44)mL,subdural effusion volume was(11.20±6.95)mL,and symptom disappearance time was(21.45±3.05)d.There were significant differences in the residual hematoma,subdural effusion,symptom disappearance time and recurrence rate between the sensitive group and non-sensitive group(all P<0.05),while there was no significant difference in incidence of intracranial air accumulation between the two groups(P>0.05).There were no significant differences in KPS,ADL or CSS scores between the two groups before treatment(all P>0.05).After treatment,the scores of KPS and ADL were higher than those before treatment,and the score

关 键 词：慢性硬膜下血肿 APOE基因 阿托伐他汀钙片 钻孔引流术 

分 类 号：R651.1[医药卫生—外科学]