介入栓塞治疗颅内前交通动脉瘤的临床疗效及其对认知功能、SDF-1A、TGF-β和炎性因子水平的影响  

Clinical Effect of Interventional Embolization in the Treatment of Intracranial Anterior Communicating Artery Aneurysm and its Influence on Cognitive Function,and the Levels of SDF-1A,TGF-and Inflammatory Factors

作　　者：王彬[1] 农海琴 叶静[1] 潘敏夫 莫胜勇[1] 符黄德[2] 罗起胜[2] 

机构地区：[1]百色市人民医院神经外科,533000 [2]右江民族医学院附属医院神经外科,533000

出　　处：《医学研究杂志》2016年第12期46-50,共5页Journal of Medical Research

基　　金：广西壮族自治区自然科学基金资助项目(2014GXNSFBA118156)

摘　　要：目的探讨介入栓塞治疗颅内前交通动脉瘤的临床疗效及其对认知功能、基质细胞衍生因子（stromal cell derived factor 1 A，SDF-1A）、转化生长因子-β（transforming growth factor-β，TGF-β）和炎性因子水平的影响。方法选取2008年2月-2014年6月间百色市人民医院神经外科诊治的68例颅内前交通动脉瘤患者为研究对象，依据治疗方案的不同将患者分为开颅动脉瘤夹闭组（对照组）和介入栓塞治疗组（栓塞组），每组各34例。分别比较两组患者的临床疗效、认知功能、SDF-1A、TGF—B和炎性因子水平的变化。结果栓塞组患者治疗良好率为55．88％（19／34），显著高于对照组的29．41％（10／34）（X^2=4．870，P=0．027）；而且，栓塞组患者的复发率仅为11．76％（4／34）也显著低于对照组的32．35％（11／34）（X^2=4．191，P=0．041）；但两组患者不良发生率比较无显著差别（X^2=0．086，P=0．770）；治疗后，栓塞组患者记忆力和回忆能力得分均较对照组明显升高（P〈O．05），但两组患者在定向能力、注意力与计算能力和语言能力方面的比较差异无统计学意义（P〉0．05）；两组患者SDF-1A、TGF-β和TNF-α的水平均明显下降，IL-10的水平则显著升高，且栓塞组患者上述4项指标的改善程度均明显优于对照组（P〈0．05）。结论介入栓塞治疗可提高颅内前交通动脉瘤的临床治疗效果，改善患者记忆和回忆力，减轻炎性应激水平。Objective To investigate the clinical effect of interventional embolization in the treatment of intracranial anterior commu- nicating artery aneurysm and its influence on cognitive function, and the levels of SDF - 1A, TGF -β and inflammatory factors. Methods The 68 cases of intracranial anterior communicating artery aneurysmin Department of Neurosurgery of People＇s Hospital of Baise were se- lected as study subjectsfrom February 2008 to June 2014. They were further divided into intracranial aneurysm clipping group （Control group） and interventional embolization group （Embolization group） , each group had 34 cases. The clinical effect, cognitive function, and the levels of SDF - 1A, TGF -β and inflammatory were compared in the two groups. Results The improvement rate of embolization group was 55.88% （19/34）, which was significantly higher than that of the control group at 29.41% （10/34） （X^2 = 4. 870, P = 0. 027 ）. The recurrence rate of embolization group was only 11.76% （4/34） , showing significantly lower than that of control group at 32.35% （ 11/ 34） （X^2 = 4. 191 , P = 0. 041 ）, but there was no significant different on the adverse occurrence rate between two groups （X^2 = 0. 086, P = 0. 770）. After treatment, the scores memory and recall abilityin the embolization group were lower than those in the control group （ P 〈 0. 05 ）, but no significant different was observed on the directional, attention and calculation and language ability （ P 〉 0.05 ）. The levels of SDF- 1A, TGF-β and TNF- α were significantly decreased in the two groups, whereas the level of IL- 10 was significantly in- creased, and the improvement of these four indexes in embolization group were all significantly better than those in the control group （P 〈 0.05）. Conclusion Interventional embolization can increase the clinical effect ofintracranial anterior communicating artery aneurysm,im- prove the memory and memory ability, and reduce the level of inflammatory stress.

关 键 词：栓塞治疗 前交通动脉瘤 认知功能 炎性因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]