颅内动脉瘤术后患者血清VEGFs、MMPs表达水平特征及对预后的预测效能  

Characteristics of VEGFs and MMPs levels in postoperative patients with intracranial aneurysm and their prognostic efficacy

作　　者：克力斯坦·夏依扎提[1] 王乐 如克亚·白克力[1] Kelisitan Xiayizhati;Wang Le;Rukeya Baikeli(Department of Neurosurgery,Xinjiang Uygur Autonomous Region People's Hospital,Xinjiang,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院神经外科,乌鲁木齐830000

出　　处：《疑难病杂志》2024年第9期1075-1079,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C428)。

摘　　要：目的探讨颅内动脉瘤术后患者血清血管内皮生长因子(VEGFs)、基质金属蛋白酶(MMPs)水平特征及对预后的预测效能。方法选取2021年12月—2023年12月就诊于新疆维吾尔自治区人民医院神经外科的颅内动脉瘤术后患者121例作为研究对象,根据术后1个月预后情况将患者分为预后良好组(n=92)和预后不良组(n=29)。采用化学发光免疫测定法检测2组患者血清VEGFs、MMPs表达谱水平;Spearman相关性分析血清VEGFs、MMPs水平与颅内动脉瘤术后患者预后不良的相关性;Logistic回归分析颅内动脉瘤术后患者预后不良的危险因素;绘制受试者工作特征(ROC)曲线分析血清VEGFs、MMPs水平预测颅内动脉瘤术后患者预后不良的价值。结果预后不良组患者血清VEGF-1、VEGF-2、MMP-1、MMP-2、MMP-9水平均显著高于预后良好组患者(t/P=4.455/<0.001、3.982/<0.001、4.848/<0.001、5.702/<0.001、5.144/<0.001);血清VEGF-1、VEGF-2、MMP-1、MMP-2、MMP-9水平均与颅内动脉瘤术后患者预后不良呈显著正相关(r/P=0.338/<0.001、0.361/<0.001、0.383/<0.001、0.386/<0.001、0.331/<0.001);血清VEGF-1、VEGF-2、MMP-1、MMP-2、MMP-9水平升高均是颅内动脉瘤术后患者预后不良的独立危险因素[OR(95%CI)=1.142(1.011~1.372)、1.126(1.004~1.276)、1.027(1.002~1.052)、1.029(1.006~1.052)、1.026(1.006~1.047)];血清VEGF-1、VEGF-2、MMP-1、MMP-2、MMP-9水平独立及联合预测颅内动脉瘤术后患者预后不良的AUC分别为0.729、0.744、0.759、0.761、0.724、0.890,联合预测的效能大于各指标独立预测效能(Z/P=4.344/<0.001、4.185/<0.001、4.013/<0.001、4.010/<0.001、4.350/<0.001)。结论颅内动脉瘤术后患者血清VEGFs、MMPs表达水平与预后不良具有密切相关性。基于上述指标的联合预测模型对颅内动脉瘤术后患者不良预后有较高预测价值。Objective To investigate the features of vascular endothelial growth factor(VEGFs)and matrix metalloproteinase(MMPs)concentrations in postoperative individuals with intracranial aneurysms and their prognostic predictive value.Methods During the period from December 2021 to December 2023,a total of 121 patients diagnosed with intracranial aneurysms were enrolled in our hospital and categorized into either the favorable prognosis group(n=92)or the unfavorable prognosis group(n=29).Comparative analyses were conducted to explore the distinctions in general clinical characteristics as well as the levels of serum VEGFs and MMPs expressions between these two groups.The study utilized Spearman correlation test and binary Logistic regression analysis to discover the potential risk factors linked to unfavorable postoperative results in individuals diagnosed with intracranial aneurysms.Moreover,the effectiveness of these risk factors in predicting the probability of an unfavorable postoperative outcome was evaluated through the receiver operating characteristic(ROC)curve analysis.Results The average serum levels of VEGF-1,VEGF-2,MMP-1,MMP-2,and MMP-9 were also significantly elevated in the poor prognosis group compared to the good prognosis group(t/P=4.455/<0.001,3.982/<0.001,4.848/<0.001,5.702/<0.001,5.144/<0.001).Spearman correlation analysis revealed a positive correlation between age,diabetes mellitus,and serum levels of VEGF-1,VEGF-2,MMP-1,MMP-2,and MMP-9 with poor prognosis among postoperative patients with intracranial aneurysms(r/P=0.338/<0.001,0.361/<0.001,0.383/<0.001,0.386/<0.001,0.331/<0.001).Additionally,multivariate Logistic regression analysis indicated that serum VEGF-1,VEGF-2,MMP-1,MMP-2,and MMP-9 were identified as pivotal risk factors for poor prognosis in patients with intracranial aneurysms post operation[OR(95%CI)=1.142(1.011-1.372),1.126(1.004-1.276),1.027(1.002-1.052),1.029(1.006-1.052),1.026(1.006-1.047)].The AUC values for serum VEGF-1,VEGF-2,MMP-1,MMP-2,MMP-9 levels independently predicting poor p

关 键 词：颅内动脉瘤 血管内皮生长因子 基质金属蛋白酶 预后 

分 类 号：R651.12[医药卫生—外科学]