摘要
目的探讨血清白细胞介素1β(IL-1β)、半胱胺酸天冬氨酸蛋白水解酶3(Caspase-3)水平与颅内动脉瘤患者术后发生脑血管痉挛的关系。方法选取2020年1月至2022年1月于北京市平谷区医院及首都医科大学附属北京天坛医院拟行介入栓塞术手术治疗的80例颅内动脉瘤患者,根据术后脑血管痉挛发生情况将其分为发生组(n=33)和未发生组(n=47)。收集所有患者的基线资料,记录所有患者的实验室指标,采用Pearson相关性检验分析血清IL-1β、Caspase-3之间的相关性,采用Logistic回归模型分析颅内动脉瘤患者术后发生脑血管痉挛的影响因素,绘制受试者工作特征曲线(ROC)分析血清IL-1β、Caspase-3对颅内动脉瘤患者术后发生脑血管痉挛的预测价值。结果发生组患者血清IL-1β、Caspase-3水平、白细胞计数均高于未发生组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,血清IL-1β、Caspase-3及白细胞计数水平升高均是颅内动脉瘤患者术后脑血管痉挛发生的危险因素(OR﹥1,P﹤0.05)。Pearson相关性检验结果显示,血清IL-1β与血清Caspase-3之间呈正相关(r=0.853,P﹤0.01)。血清IL-1β、Caspase-3及两者联合预测颅内动脉瘤患者术后发生脑血管痉挛的曲线下面积(AUC)分别为0.784、0.783、0.845,预测价值均较高,两者联合预测的AUC最大。结论颅内动脉瘤患者术后脑血管痉挛发生风险较高,血清IL-1β、Caspase-3水平升高与颅内动脉瘤患者术后脑血管痉挛发生有关,且两者联合预测术后脑血管痉挛发生的效能较高,可能成为临床预测术后发生脑血管痉挛及治疗靶点的生物学指标。
Objective To investigate the relationship between serum levels of interleukin-1β(IL-1β),cysteine aspartate proteolytic enzyme 3(Caspase-3)and postoperative cerebral vasospasm in patients with intracranial aneurysms.Method Eighty patients with intracranial aneurysms who underwent interventional embolization surgery from January 2020 to January 2022 in Beijng Pinggu Hospital and Beijing Tiantan Hospital,Capital Medical University were selected and divided into occurring group(n=33)and non occurring group(n=47)based on the occurrence of postoperative cerebral vasospasm.Baseline data of all patients were collected,laboratory indicators of all patients were recorded,the correlation between serum IL-1βand Caspase-3 were analyzed by Pearson,the influencing factors of postoperative cerebral vasospasm in patients with intracranial aneurysm were analyzed by Logistic regression model.Receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of serum IL-1βand Caspase-3 on postoperative cerebral vasospasm in patients with intracranial aneurysm.Result Serum levels of IL-1β,Caspase-3 and white blood cell count in occurrence group were higher than those in non occurring group,the differences were statistically significant(P<0.05).Multifactor analysis showed that increased levels of serum IL-1β,Caspase-3 and white blood cell count were risk factors for postoperative cerebral vasospasm in patients with intracranial aneurysm(OR>1,P<0.05).Pearson correlation test showed that serum IL-1βwas positively correlated with serum Caspase-3(r=0.853,P<0.01).The area under the curve(AUC)of serum IL-1β,Caspase-3 and their combination in predicting postoperative cerebral vasospasm in patients with intracranial aneurysm were 0.784,0.783 and 0.845,respectively,with high predictive value,and the AUC predicted by the combination was the largest.Conclusion Patients with intracranial aneurysms have higher risk of postoperative cerebral vasospasm,the serum levels of IL-1βand Caspase-3 are associated with postoperative cerebral vasospasm in patients with intracranial aneurysms,and their combined prediction of postoperative cerebral vasospasm is highly effective,which may become a biological indicator for clinical prediction of postoperative cerebral vasospasm and treatment targets.
作者
张云鹏
陈小帅
王岩
李玉明
李昊
Zhang Yunpeng;Chen Xiaoshuai;Wang Yan;Li Yuming;Li Hao(Department of Neurosurgery,Beijing Pinggu Hospital,Beijing 101200,China;Neurovascular Ward I,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《血管与腔内血管外科杂志》
2024年第1期88-92,共5页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金项目(8200051081)。
