双LVIS支架辅助栓塞治疗急性期颅内宽颈动脉瘤的疗效及其与SICAM-1、S100B水平的关系  

Efficacy of double low-profile visualized intraluminal support stent assisted embolization in treatment of acute intracranial wide-neck aneurysms and its relation with levels of soluble intercellular adhesion molecule-1 and S100B

作　　者：余惠平[1] 蔡昭文 黄建兴[1] 张和平[1] Yu Huiping;Cai Zhaowen;Huang Jianxing;Zhang Heping(Department of Neurosurgery, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362000, China)

机构地区：[1]福建医科大学附属泉州第一医院神经外科,泉州362000

出　　处：《中华神经医学杂志》2019年第9期922-926,共5页Chinese Journal of Neuromedicine

摘　　要：目的探究双低剖面可视化腔内支撑装置(LVIS)支架辅助栓塞治疗急性期颅内宽颈动脉瘤患者的疗效及其与血清可溶性细胞间黏附分子-1(SICAM-1)、S100B蛋白水平的关系。方法选择福建医科大学附属泉州第一医院神经外科自2014年6月至2018年12月收治的急性期颅内宽颈动脉瘤患者114例,其中采用双LVIS支架辅助栓塞治疗患者58例(研究组),采用单LVIS支架辅助栓塞治疗患者56例(对照组)。术后即刻采用Raymond分级评价颅内宽颈动脉瘤的栓塞程度,出院时采用改良Rankin量表(mRS)评估患者的疗效,比较不同治疗方式、不同疗效患者手术前、后血清SICAM-1、S100B蛋白水平。结果研究组患者术后即刻动脉瘤栓塞程度、出院时疗效良好率均高于对照组,差异均有统计学意义(P<0.05);研究组患者术后血清SICAM-1、S100B蛋白水平均低于对照组,差异均有统计学意义(P<0.05);术后疗效良好组患者血清SICAM-1、S100B蛋白水平[(147.5±9.8) mg/mL、(0.106±0.027) mg/mL]均低于疗效不良组患者[(172.8±4.0) mg/mL、(0.158±0.002) mg/mL],差异有统计学意义(P<0.05)。结论双LVIS支架辅助栓塞治疗急性期颅内宽颈动脉瘤可明显提高致密栓塞程度,疗效较好。疗效不良患者血清SICAM-1和S100B蛋白水平明显升高。Objective To explore the efficacy of double low-profile visualized intraluminal support (LVIS) stent assisted embolization in the treatment of acute intracranial wide-neck aneurysms and its relation with levels of soluble intercellular adhesion molecule-1 (SICAM-1) and S100B. Methods A total of 114 patients with acute intracranial wide-neck aneurysms admitted to our hospital from June 2014 to December 2018 were collected. According to different treatment options, the patients in the study group (n=58) were treated with double LVIS stent-assisted embolization, while those in the control group (n=56) were treated with LVIS stent-assisted embolization. The embolization degrees of intracranial wide-necked aneurysms were evaluated by Raymond grading immediately after surgery, the efficacy of the patients was evaluated by modified Rankin scale (mRS) at discharge, and the serum SICAM-1 and S100B protein levels of the patients with different treatment methods and different curative effects before and after surgery were compared. Results As compared with those in the control group, the degrees of arterial embolization immediately after surgery and good therapeutic effect rate at discharge were significantly higher in the study group (P<0.05). After treatment, the serum levels of SICAM-1 and S100B were significantly lower in the study group than those in the control group (P<0.05). The levels of SICAM-1 and S100B in patients with good therapeutic effect ([147.5±9.8] mg/mL and [0.106±0.027] mg/mL) were significantly lower than those in the patients with poor therapeutic effect ([172.8±4.0] mg/mL and [0.158±0.002] mg/mL, P<0.05). Conclusions The embolization rate and therapeutic effect can be significantly improved in patients with acute intracranial wide-neck aneurysms after double-LVIS stent-assisted embolization. The serum levels of SICAM-1 and S100B are significantly increased in patients with poor therapeutic effect.

关 键 词：颅内宽颈动脉瘤 双低剖面可视化腔内支撑装置支架 可溶性细胞间黏附分子-1 S100B 疗效 

分 类 号：R651[医药卫生—外科学]