早期、晚期介入栓塞术用于颅内动脉瘤患者改善神经功能、精神状态、生活能力的价值研究  

Early and late interventional embolization can improve neurological function,mental state and living ability of patients with intracranial aneurysm

作　　者：赵杨凯 朱邦选 项以力 吴明亮 王守义 Zhao Yangkai;Zhu Bangxuan;Xiang Yi;Wu Mingliang;Wang Shouyi(Graduate School of Zhejiang Chinese Medical University,Hangzhou 310000,Zhejiang Province,China;Department of Interventional Vascular Surgery,Wenzhou People's Hospital,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]浙江中医药大学研究生院,杭州310000 [2]温州市人民医院介入血管科,温州325000

出　　处：《中国基层医药》2022年第9期1320-1324,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划项目(2019ZH038)。

摘　　要：目的探讨早期、晚期介入栓塞术在颅内动脉瘤中的应用价值。方法选取温州市人民医院2015年10月至2020年2月收治的颅内动脉瘤患者82例,根据手术距发病时间分为早期组和晚期组各41例。早期组采取早期(≤3 d)介入栓塞术,晚期组采取晚期(≥3 d)介入栓塞术。统计两组栓塞效果、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及出院时改良Barthel指数(MBI)、简易精神状态检查量表(MMSE)评分、基质金属蛋白酶9(MMP-9)、可溶性细胞间黏附分子1(sICAM-1)水平以及预后。结果早期组栓塞效果优于晚期组,差异有统计学意义(P=0.046);治疗后早期组NIHSS评分[(4.02±1.64)分]低于晚期组[(6.81±2.02)分],MMSE评分[(28.09±1.35)分]及MBI评分[(81.12±9.67)分]均高于晚期组[(26.01±1.19)分、(73.02±8.19)分],差异均有统计学意义(t=6.86、7.40、4.09,均P<0.001);治疗后早期组MMP-9[(420.33±29.40)μg/L]及sICAM-1[(403.70±23.28)μg/L]均低于晚期组[(491.30±31.19)μg/L、(496.37±30.46)μg/L],差异均有统计学意义(t=10.60、15.47均P<0.001);早期组预后效果优于晚期组,差异有统计学意义(P=0.049)。结论早期采取介入栓塞术治疗颅内动脉瘤效果优于晚期介入治疗,可更有效改善患者神经功能及精神状态,提高生活能力,改善预后,可能与调节MMP-9及sICAM-1含量有关。Objective To investigate the application value of early and late interventional embolization in intracranial aneurysms.Methods Eighty-two patients with intracranial aneurysm who received treatment in Wenzhou People's Hospital from October 2015 to February 2020 were included in this study.These patients were divided into early(≤3 days)and late(>3 days)groups,with 41 patients in each group,according to time from disease onset to surgery.The early group was subjected to early interventional embolization,and the late group was treated with late interventional embolization.The effects of embolization and National Institutes of Health Stroke Scale score pre-and post-treatment,as well as modified Barthel index,Mini-Mental State Exam score,matrix metalloproteinase-9 level,and soluble intercellular adhesion molecule-1 level post-treatment and prognosis were compared between the two groups.Results The embolization effects in the early group were statistically superior to those in the late group(P=0.046).After treatment,National Institutes of Health Stroke Scale score in the early group was significantly lower than that in the late group[(4.02±1.64)points vs.(6.81±2.02)points,t=6.86,P<0.01].Mini-Mental State Exam score and modified Barthel index in the early group were(28.09±1.35)points and(81.12±9.67)points,respectively,which were significantly higher than(26.01±1.19)points and(73.02±8.19)points in the late group(t=7.40,4.09,both P<0.001).After treatment,matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels in the early group were(420.33±29.40)μg/L and(403.70±23.28)ug/L,respectively,which were significantly lower than(491.30±31.19)μg/mL and(496.37±30.46)μg/L in the late group(t=10.60,15.47,both P<0.001).Prognosis in the early group was superior to that in the late group(P=0.049).Conclusion Early interventional embolization has better efficacy than late interventional embolization in the treatment of intracranial aneurysm.The former can effectively improve neurological function and m

关 键 词：颅内动脉瘤 颅内栓塞 精神状态检查表 生活质量 基质金属蛋白酶9 细胞黏附分子 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]