血浆纤维连接蛋白1对颅内动脉瘤破裂的预测价值  

Predictive value of plasma fibronectin 1 in intracranial aneurysm rupture

作　　者：刘飞飞 韩丽君 申友奎[1] 徐良 LIU Feifei;HAN Lijun;SHEN Youkui;XU Liang(Department of Neurosurgery,Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China;不详)

机构地区：[1]浙江中医药大学附属杭州市中医院神经外科,310007 [2]浙江中医药大学附属杭州市中医院体检中心,310007 [3]浙江大学医学院附属第二医院神经外科

出　　处：《心电与循环》2022年第2期130-133,共4页Journal of Electrocardiology and Circulation

基　　金：浙江省中医药科技计划项目(2021ZA105);浙江省基础公益研究计划项目(LQ19H160039)。

摘　　要：目的 探讨血浆纤维连接蛋白1(FN1)对颅内动脉瘤(IA)破裂的预测价值。方法 选取2019年11月至2020年11月在浙江大学医学院附属第二医院住院治疗的201例IA患者为研究对象,其中IA破裂94例,未破裂107例。比较IA破裂与未破裂患者的临床资料,采用多因素logistic回归分析IA破裂的影响因素,绘制ROC曲线分析血浆FN1水平预测IA破裂的效能。结果 IA破裂与未破裂患者在动脉瘤位置、形态、有无子囊及血浆FN1水平等方面比较,差异均有统计学意义(均P<0.05);在性别、年龄、体重指数、合并高血压比例、动脉瘤直径、多发动脉瘤比例等方面比较,差异均无统计学意义(均P>0.05)。多因素logistic回归分析显示,血浆FN1水平、非颈内动脉的动脉瘤、有无子囊是IA破裂的独立影响因素(均P<0.05)。血浆FN1水平预测IA破裂的AUC为0.621(最佳截断值为389 mg/L),灵敏度、特异度、约登指数分别为0.489、0.748、0.237。结论 血浆FN1水平是IA破裂的独立影响因素,且对IA破裂具有一定的预测效能。Objective To investigate the predictive value of plasma fibronectin 1(FN1) on the rupture of intracranial aneurysm(IA). Methods A total of 201 IA patients who were hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine from November 2019 to November 2020 were included. Of them, 94 were ruptured and 107were unruptured. The clinical data were compared between the patients with ruptured IA and unruptured IA. Multivariate logistic regression was used to analyze the risk factors of IA rupture. A receiver operating characteristic curve was drawn to analyze the diagnostic efficacy of plasma FN1 in predicting IA rupture. Results There were significant differences between patients with ruptured and unruptured IA in terms of aneurysm location, morphology, presence of bleb and plasma FN1 level(all P<0.05). There was no significant difference in gender, age, body mass index, blood pressure,aneurysm diameter, and multiple aneurysm between the two groups(all P >0.05). Multivariate logistic regression analysis showed that plasma FN1 level, non-internal carotid artery aneurysm, and the presence of bleb were independent risk factors of IA rupture(all P<0.05). The AUC of plasma FN1 level for predicting IA rupture was 0.621(the best cut-off value was 389 mg/L), and the sensitivity, specificity, and Youden index were 0.489, 0.748, and 0.237, respectively. Conclusion Plasma FN1 level is an independent risk factor of IA rupture and has a certain predictive value for IA rupture.

关 键 词：颅内动脉瘤 纤维连接蛋白1 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]