Wang Bo, Li Kangqi, Guo Chenyu, Wang Zhe, Zhu Weiwei, Lu Congxiao
Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, Shandong, China.
Ann Indian Acad Neurol. 2024 Jan-Feb;27(1):19-26. doi: 10.4103/aian.aian_818_23. Epub 2024 Feb 6.
Chronic subdural hematoma (CSDH) is a chronic space-occupying lesion formed by blood accumulation between the arachnoid membrane and the dura mater. Atorvastatin is of increasing clinical interest for CSDH. We performed a meta-analysis of published randomized controlled trials (RCTs) and used objective data as the primary outcomes to provide an evidence-based analysis of the efficacy of atorvastatin for CSDH treatment. Databases of MEDLINE (via PubMed), EMBASE, the Cochrane Library, Scopus, Web of Science, ScienceDirect, Chinese National Knowledge Infrastructure (CNKI), Cqvip database (CQVIP), and Wanfang database were systematically searched for RCTs reporting the use of atorvastatin for CSDH treatment. Odds ratio (OR), standard mean difference (SMD), and 95% confidence intervals (CIs) were used as summary statistics. I-square () test was performed to assess the impact of study heterogeneity on the results of the meta-analysis. Nine relevant RCTs with 611 patients were identified for inclusion in this meta-analysis. Compared to controls, atorvastatin treatment had a significantly higher effectiveness (OR: 7.41, 95% CI: 3.32-16.52, < 0.00001, = 0%), lower hematoma volume (SMD: -0.46. 95% CI: -0.71 to -0.20, = 0.0005, = 0%), higher activities of daily living-Barthel Index (ADL-BI) (SMD: 2.07, 95% CI: 1.06-3.09, < 0.0001, = 92%), and smaller Chinese stroke scale (CSS) (SMD: -1.10, 95% CI: -1.72 to -0.48, = 0.0005, = 57%). In view of these findings, we conclude that the outcomes of experimental group are superior to the control group with respect to effectiveness, hematoma volume, ADL-BI, and CSS based on nine RCTs with 611 patients. Atorvastatin is beneficial to CSDH patients without surgery.
慢性硬膜下血肿（CSDH）是一种由蛛网膜与硬脑膜之间血液积聚形成的慢性占位性病变。阿托伐他汀在CSDH治疗方面越来越受到临床关注。我们对已发表的随机对照试验（RCT）进行了荟萃分析，并将客观数据作为主要结局，以对阿托伐他汀治疗CSDH的疗效进行循证分析。通过系统检索MEDLINE（通过PubMed）、EMBASE、Cochrane图书馆、Scopus、科学网、ScienceDirect、中国知网（CNKI）、维普数据库（CQVIP）和万方数据库，查找报告使用阿托伐他汀治疗CSDH的RCT。比值比（OR）、标准均差（SMD）和95%置信区间（CI）用作汇总统计量。进行I²检验以评估研究异质性对荟萃分析结果的影响。确定了9项涉及611例患者的相关RCT纳入本荟萃分析。与对照组相比，阿托伐他汀治疗的有效性显著更高（OR：7.41，95%CI：3.32 - 16.52，P < 0.00001，I² = 0%），血肿体积更低（SMD：-0.46，95%CI：-0.71至-0.20，P = 0.0005，I² = 0%），日常生活活动能力-巴氏指数（ADL-BI）更高（SMD：2.07，95%CI：1.06 - 3.09，P < 0.0001，I² = 92%），以及中国卒中量表（CSS）更小（SMD：-1.10，95%CI：-1.72至-0.48，P = 0.0005，I² = 57%）。鉴于这些发现，基于9项涉及611例患者的RCT，我们得出结论，在有效性、血肿体积、ADL-BI和CSS方面，实验组的结局优于对照组。阿托伐他汀对无需手术的CSDH患者有益。
