血清可溶性细胞间黏附分子1、半胱氨酸天冬氨酸蛋白水解酶3水平对颅内破裂动脉瘤术后脑血管痉挛的预测价值  

Predictive value of serum soluble intercellular adhesion molecule 1 and cysteine aspartate proteolytic enzyme 3 levels in cerebral vasospasm after intracranial ruptured aneurysm surgery

作　　者：尹航[1] 冯丽君[1] 肖龙海[1] 李长歌 秦浩[1] YIN Hang;FENG Lijun;XIAO Longhai;LI Changge;QIN Hao(Department of Neurosurgery,Zaozhuang Municipal Hospital,Shandong Province,Zaozhuang 277100,China)

机构地区：[1]山东省枣庄市立医院神经外科,山东枣庄277100

出　　处：《中国医药导报》2021年第14期67-71,共5页China Medical Herald

基　　金：山东省医药卫生科技发展计划项目(2018WS019)。

摘　　要：目的探讨血清可溶性细胞间黏附分子1(SICAM-1)、半胱氨酸天冬氨酸蛋白水解酶3(Caspase-3)水平在颅内破裂动脉瘤术后脑血管痉挛(CVS)的预测价值。方法选取2016年1月—2019年12月山东省枣庄市立医院收治的203例颅内动脉瘤破裂蛛网膜下腔出血(SAH)患者,均接受开颅夹闭或介入栓塞治疗,术后4 d行数字减影血管造影,根据术后不同程度CVS将其分为重度CVS组(19例)、中度CVS组(44例)、轻度CVS组(23例)、无CVS组(117例)。检测术前和术后3、7 d血清Caspase-3、SICAM-1水平。比较四组颅内破裂动脉瘤术前后血清SICAM-1、Caspase-3水平,Pearson相关系数分析颅内破裂动脉瘤术后血清SICAM-1与Caspase-3水平的相关性;绘制受试者工作特征(ROC)曲线,判断术后3 d血清SICAM-1、Caspase-3对颅内破裂动脉瘤术后CVS的预测价值。结果四组术后3、7 d血清SICAM-1、Caspase-3水平均高于术前,术后7 d血清SICAM-1、Caspase-3水平均低于术后3 d(P<0.05)。Pearson相关性分析显示,颅内破裂动脉瘤术后3、7 d血清SICAM-1与Caspase-3水平呈正相关(r=0.493、0.585,P<0.05)。ROC曲线显示,术后3 d血清SICAM-1+Caspase-3诊断颅内破裂动脉瘤术后CVS的曲线下面积、敏感度、特异性均高于SICAM-1和Caspase-3单独检测。结论颅内破裂动脉瘤术后CVS患者血清SICAM-1、Caspase-3水平明显提升,联合检测可有效预测CVS发生。Objective To investigate the predictive value of serum soluble intercellular adhesion molecule 1(SICAM-1)and cysteine aspartate proteolytic enzyme 3(caspase-3)levels in cerebral vasospasm(CVS)after intracranial ruptured aneurysm surgery.Methods A total of 203 patients with ruptured intracranial aneurysm subarachnoid hemorrhage(SAH)admitted to Zaozhuang Municipal Hospital,Shandong Province from January 2016 to December 2019 were selected.All of them received craniotomy clipping or interventional embolization treatment,and underwent digital subtraction angiography four days after surgery.According to different degrees of postoperative CVS,they were divided into severe CVS group(19 cases),moderate CVS group(44 cases),mild CVS group(23 cases)and no CVS group(117 cases).Serum levels of caspase-3 and SICAM-1 were detected before and 3,7 days after surgery.The serum levels of SICAM-1 and caspase-3 in the four groups were compared before and after intracranial ruptured aneurysm.The correlation between serum SICAM-1 and caspase-3 after intracranial ruptured aneurysm was analyzed by Pearson correlation coefficient.Receiver operating characteristic(ROC)curve was drawn to determine the predictive value of serum SICAM-1 and caspase-3 on postoperative CVS of ruptured intracranial aneurysm three days after surgery.Results Serum levels of SICAM-1 and caspase-3 in the four groups 3 and 7 days after surgery were higher than those before surgery,and serum levels of SICAM-1 and caspase-3 seven days after surgery were lower than those three days after surgery(P<0.05).Pearson correlation andlysisshowed that there was a positive correlation between serum SICAM-1 and caspase-3 levels of ruptured intracranial aneurysm 3 and 7 days after surgery(r=0.493,0.585,P < 0.05). The ROC curve showed that the area under the curve, sensitivity and specificity of SICAM-1 + caspase-3 in the diagnosis of postoperative CVS of ruptured intracranial aneurysm 3 days after surgery were higher than those of SICAM-1 and caspase-3 alone. Conclusion Serum level

关 键 词：颅内破裂动脉瘤 脑血管痉挛 可溶性细胞间黏附分子1 半胱氨酸天冬氨酸蛋白水解酶3 预测价值 

分 类 号：R651[医药卫生—外科学] R743.35[医药卫生—临床医学]