罗格列酮联合微创颅内血肿清除术治疗高血压脑出血临床研究

目的：观察罗格列酮联合微创颅内血肿清除术治疗高血压脑出血(HICH)的临床疗效。方法将2013年10月至2015年10月在衡水市第四人民医院神经外科接受治疗的82例HICH患者按照随机数字表法均分为观察组和对照组，每组41例。对照组实施微创颅内血肿清除术治疗，观察组在对照组治疗基础上加用罗格列酮治疗，采用美国国立卫生研究院卒中量表(NIHSS)评定患者治疗前后神经功能缺损评分，判定其疗效，并测定患者治疗前后血清中的基质金属蛋白酶-9(MMP-9)水平和统计不良反应。结果观察组治疗总有效率为85.37%(35/41)，明显高于对照组的73.17%(30/41)，差异有统计学意义(P<0.05)；观察组患者治疗后的NIHSS评分和血清MMP-9水平分别为(1.84±1.58)分、(156.35±58.83) ng/mL，明显低于对照组的(3.36±1.56)分、(190.72±50.01) ng/mL，差异均有统计学意义(P<0.05)；两组治疗期间均未见肝、肾功能损害等严重并发症。结论罗格列酮联合微创颅内血肿清除术治疗高血压脑出血能有效提高治疗效果，促进神经功能恢复，降低血清MMP-9水平，是一种安全、有效的治疗方案。

Clinical study of rosiglitazone combined with minimally invasive intracranial hematoma in treatment of hypertensive intracerebral hemorrhage

Objective To observe the clinical effect of rosiglitazone combined with minimally invasive intra-cranial hematoma in treatment of hypertensive intracerebral hemorrhage (HICH). Methods Eighty-two patients withHICH who received treatment in Department of Neurosurgery in the Fourth People's Hospital of Hengshui from October 2013 to October 2015 were randomly divided into observation group and control group according to the random number table, with 41 patients in each group. The control group was treated with minimally invasive intracranial hematoma, and the observation group was treated with rosiglitazone on the basis of the control group. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurologic impairment score of patients before and after treatment. The clini-cal efficacy was determined, and the levels of serum matrix metalloproteinase-9 (MMP-9) and adverse reactions before and after treatment were recorded. Results The total efficiency of observation group was 85.37%(35/41), which was significantly higher than that of the control group of 73.17% (30/41), with statistically significant difference (P<0.05). The NIHSS score and serum MMP-9 levels of observation group were respectively (1.84±1.58), (156.35±58.83) ng/mL, which were significantly lower than those of control group of (3.36±1.56), (190.72±50.01) ng/mL, with statistically sig-nificant differences (P<0.05). There were no serious complications such as liver and renal function damage in the two groups during the treatment period. Conclusion Rosiglitazone combined with minimally invasive intracranial hemato-ma in treatment of hypertensive intracerebral hemorrhage can effectively improve the therapeutic effect, promote the re-covery of neurological function and reduce the level of serum MMP-9. It is a safe and effective therapeutic regimen.