神经轴突导向因子3E与颅内动脉瘤介入栓塞术后1个月不良预后的关系  

Study on Correlation Between Semaphorin 3E and 1-month Poor Prognosis After Interventional Embolization in Patients With Intracranial Aneurysm

作　　者：谢昌纪[1] 杨辰龙 周志宇[1] 胡瑞婷[3] 黄俊萍 谭呼 韦馨娴 王涛[2] 杨军 Xie Changji;Yang Chenlong;Zhou Zhiyu(Department of Neurosurgery,Ethnic Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院神经外科,南宁530001 [2]北京大学第三医院神经外科,北京100191 [3]广西壮族自治区民族医院神经内科,南宁530001

出　　处：《中国微创外科杂志》2024年第3期167-172,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200879);广西高校中青年教师科研基础能力提升项目(2021KY0080);崇左市科技局科技计划项目(崇科FA2018020)。

摘　　要：目的研究颅内动脉瘤患者血清神经轴突导向因子3E(semaphorin 3E,Sema3E)水平与颅内动脉瘤介入栓塞术后1个月不良预后的关系。方法本研究为前瞻性单中心队列研究,连续纳入2020年6月~2022年1月广西壮族自治区民族医院介入手术治疗颅内动脉瘤102例,其中11例被剔除。收集临床及影像学资料,入院后采集外周血,利用酶联免疫吸附试验测定血清Sema3E水平。均行血管内介入弹簧圈栓塞或支架辅助弹簧圈栓塞治疗。主要结局为介入治疗1个月后的格拉斯哥结局评分(Glasgow Outcome Scale,GOS),预后良好定义为GOS评分4~5分,预后不良定义为GOS评分1~3分(严重残疾、植物状态生存或死亡)。利用单因素及多因素logistic回归分析评估预后良好组与预后不良组间临床特征及血清Sema3E水平的差异。结果研究纳入的91例颅内动脉瘤年龄(59.9±11.0)岁,预后良好组70例(76.9%),预后不良组21例(23.1%)。预后不良组术前格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)(9.4±4.5)显著低于预后良好组(13.3±2.5)(P<0.001),Hunt-Hess分级(3.6±0.6 vs.2.0±1.3,P<0.001)和血清Sema3E水平[(6.21±1.58)μg/L vs.(4.38±1.77)μg/L,P<0.001]均显著高于预后良好组。logistic回归分析显示Hunt-Hess分级(OR=7.150,P=0.003)、采用支架辅助弹簧圈栓塞(OR=15.777,P=0.010)、血清Sema3E水平(OR=1.756,P=0.027)是颅内动脉瘤介入治疗不良预后的独立影响因素。结论颅内动脉瘤患者血清Sema3E水平与病情严重程度关系密切。血清Sema3E水平是动脉瘤患者介入治疗的预后影响因素,高Sema3E水平可作为预测动脉瘤介入治疗后不良结局的生物标记物。Objective To investigate the serum levels of semaphorin 3E(Sema3E)in patients with intracranial aneurysms,revealing the correlation between Sema3E and 1-month poor prognosis after interventional embolization.Methods This study was a prospective single-center cohort study,recruiting 102 consecutive patients with intracranial aneurysms who underwent interventional surgery from June 2020 to January 2022 in our hospital.Among them,11 patients were excluded.Clinical and radiological profiles were collected.Peripheral blood was collected after admission,and serum Sema3E levels were determined by enzyme-linked immunosorbent assay.All the aneurysms were treated with endovascular coil embolization or stent-assisted coil embolization.The primary outcome was evaluated with the Glasgow Outcome Scale(GOS)1 month after interventional therapy.The favorable outcome was defined as a GOS score of 4-5,and a poor outcome was defined as a GOS score of 1-3(severe disability,vegetative state,or death).Univariate and multivariate logistic regression analyses were used to identify potential prognostic factors after interventional therapy.Results The average age of 91 patients with intracranial aneurysm was 59.9±11.0 years old,including 70 cases(76.9%)with favorable prognosis and 21 cases(23.1%)with poor prognosis.The mean preoperative Glasgow Coma Scale(GCS)score of the poor prognosis group(9.4±4.5)was significantly lower than that of the favorable prognosis group(13.3±2.5;P<0.001).In the poor prognosis group,the Hunt-Hess grade(3.6±0.6 vs.2.0±1.3,P<0.001)and the serum Sema3E levels[(6.21±1.58)μg/L vs.(4.38±1.77)μg/L,P<0.001]were significantly higher than those in the favorable prognosis group.Logistic regression analysis showed the Hunt-Hess grade(OR=7.150,P=0.003),stent-assisted coil embolization(OR=15.777,P=0.010),and the serum Sema3E level(OR=1.756,P=0.027)were independent prognostic factors for intracranial aneurysms after interventional therapy.Conclusions The serum Sema3E level is closely correlated with the severity of i

关 键 词：动脉瘤 神经轴突导向因子3E 介入治疗 预后因素 

分 类 号：R651.12[医药卫生—外科学]