目的 探讨舒血宁注射液联合阿托伐他汀治疗慢性硬膜下血肿的临床疗效。方法 选取2016年1月-2017年1月在天津医科大学总医院滨海医院治疗的慢性硬膜下血肿患者76例，依据治疗方案的差别分为对照组（38例）和治疗组（38例）。对照组口服阿托伐他汀钙片，20 mg/次，1次/d。治疗组在对照组的基础上静脉滴注舒血宁注射液，20 mL加入5%葡萄糖溶液250 mL，1次/d。两组患者均治疗30 d。评价两组患者临床疗效，同时比较治疗前后两组患者CSS和ADL评分以及血肿量和血清学指标。结果 治疗后，对照组和治疗组的总有效率分别为81.58%、97.37%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组CSS评分与血肿量均显著降低，ADL评分升高，同组比较差异具有统计学意义（P<0.05）；且治疗组CSS和ADL评分及血肿量均显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）、基质金属蛋白酶-9（MMP-9）、脑源性神经营养因子（BDNF）水平显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗组上述血清学指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 舒血宁注射液联合阿托伐他汀治疗慢性硬膜下血肿临床疗效显著，可有效改善神经功能和促进血肿吸收，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Shuxuening Injection combined with atorvastatin in treatment of elderly patients with chronic subdural hematoma. Methods Patients (76 cases) with chronic subdural hematoma in Binhai Hospital of General Hospital Affiliated to Tianjin Medical University from January 2016 to January 2017 were divided into control (38 cases) and treatment (38 cases) groups based on different treatments. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were iv administered with Shuxuening Injection on the basis of the control group, 20 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 30 d. After treatment, clinical efficacy was evaluated, and the CSS and ADL scores, hematoma volume and serological indicators in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.58% and 97.37%, respectively, and there were differences between two groups (P<0.05). After treatment, the CSS scores and hematoma volume in two groups were significantly decreased, but ADL scores were significantly increased, and the difference was statistically significant in the same group (P<0.05). The CSS score, ADL score, and hematoma volume in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the serum NSE, MMP-9, and BDNF levels in two groups were significantly decreased, and there were differences in the same group (P<0.05). And these serological indicators in the treatment group were obviously lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Shuxuening Injection combined with atorvastatin has clinical significant effect in treatment of elderly patients with chronic subdural hematoma, can effectively improve the nerve function and promote the absorption of hematoma, which has a certain clinical application value.

天津市应用基础与前沿技术研究计划重点项目（15JCZDJC36500）