脑脊液中IL-17A表达与交通性脑积水患者临床预后的分析  

IL-17A as a potential prognostic biomarker in communicating hydrocephalus patients

作　　者：林海[1] 叶忠兴 林玲[1] 胡瑜玲 王蕊 张文静 唐文龙 LIN Hai;YE Zhong-xing;LIN Ling;HU Yu-ling;WANG Rui;ZHANG Wen-jing;TANG Wen-long(Department of Neurosurgery,the Second People′s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院神经外科,福州350003

出　　处：《岭南现代临床外科》2024年第6期378-383,共6页Lingnan Modern Clinics in Surgery

基　　金：福建省自然科学基金计划项目(2022J01121051)。

摘　　要：目的本研究旨在探讨交通性脑积水患者术前脑脊液中白介素17A(IL-17A)水平对其临床预后的预测价值。方法回顾性分析2019年1月至2023年12月期间福建中医药大学附属第二人民医院神经外科收治的54例交通性脑积水患者的临床数据。所有入选患者均于术前接受了腰椎穿刺以收集脑脊液样本,检测脑脊液中的IL-17A水平。分别在术后4周和术后3年采用美国国立卫生研究院卒中量表(NIHSS)对患者的临床疗效进行评估,进而分析脑脊液IL-17A水平与临床疗效之间的潜在关系。结果研究数据显示,术前症状较为严重的患者脑脊液中IL-17A的表达水平较高。在术后4周的疗效评估中,我们发现90.7%的患者症状得到了显著改善,但脑脊液IL-17A的表达水平与术后即刻疗效之间的关联性并不显著。然而,在术后3年的长期疗效评估中,结果显示患者的NIHSS评分显著低于术前水平,且治疗疗效较好的患者脑脊液中IL-17A水平明显低于疗效较差的患者(P<0.05)。此外,出现不良反应的患者的脑脊液IL-17A的表达显著高于未出现不良反应的患者。结论本研究表明,脑脊液中IL-17A的表达水平可作为预测交通性脑积水患者临床长期预后的一个有效指标。这一发现为交通性脑积水的临床治疗提供了新的视角和潜在的干预靶点。Objective This study aimed to explore the predictive value of preoperative cerebrospinal fluid(CSF)interleukin-17a(IL-17A)levels for the clinical prognosis of patients with communicating hydrocephalus.Methods This study retrospectively analyzed the clinical data of 54 patients with com-municating hydrocephalus admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine from January 2019 to December 2023.All selected patients underwent lumbar puncture before surgery to collect CSF samples for IL-17A level detection.The clinical efficacy of the patients was evaluated using the National Institutes of Health Stroke Scale(NIHSS)at 4 weeks and 3 years after surgery,and the potential relationship between CSF IL-17A levels and clini-cal efficacy was analyzed.Results The study data showed that patients with more severe preoperative symptoms had higher IL-17A expression levels in CSF.In the efficacy assessment at 4 weeks after surgery,90.7%of the patients showed significant improvement in symptoms,but the association between CSF IL-17A levels and immediate postoperative efficacy was not significant.However,in the long-term efficacy assessment at 3 years after surgery,the NIHSS scores of the patients were significantly lower than those before surgery,and the CSF IL-17A levels of patients with better treatment efficacy were significantly lower than those with poorer efficacy(P<0.05).Additionally,the study indicated that patients with adverse reactions had significantly higher IL-17A expression levels in CSF than those without adverse reactions.Conclusion This study demonstrated that the expression level of IL-17A in CSF can serve as an effective indicator for predicting the long-term clinical prognosis of patients with communicating hydrocephalus.This finding provides a new perspective and potential intervention target for the clinical treatment of communicating hydrocephalus.

关 键 词：白介素17A 交通性脑积水 临床疗效 

分 类 号：R651.1[医药卫生—外科学]