血管内介入栓塞术对脑动脉瘤患者血清炎症因子、氧化应激及脑血管状态的影响  

Effects of endovascular interventional embolization on serum inflammatory factors,oxidative stress,and cerebrovascular status in patients with cerebral aneurysm

作　　者：巨岩 史波 杨德民 Ju Yan;Shi Bo;Yang Demin(Second Department of Neurology,Yangling Demonstration Zone Hospital,Xianyang 712100,China;First Department of Neurology,Yangling Demonstration Zone Hospital,Xianyang 712100,China)

机构地区：[1]杨凌示范区医院神经内二科,咸阳712100 [2]杨凌示范区医院神经内一科,咸阳712100

出　　处：《国际医药卫生导报》2025年第4期568-572,共5页International Medicine and Health Guidance News

基　　金：国家自然科学基金(82171181)。

摘　　要：目的分析血管内介入栓塞术对脑动脉瘤患者血清炎症因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)]、氧化应激[前列腺素E2(PGE2)、促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)]及脑血管状态[平均血流速度(Vm)、收缩期峰值流速(Vs)、舒张期末血流速度(Vd)、搏动指数(PI)值]的影响。方法采用回顾性分析,选取2021年7月至2023年12月杨凌示范区医院收治的98例脑动脉瘤患者。其中,接受开颅夹闭术治疗的47例患者作为对照组,男26例,女21例,年龄(49.20±2.01)岁;接受血管内介入栓塞术治疗的51例患者作为观察组,男31例,女20例,年龄(50.98±2.40)岁。比较两组患者的IL-6、IL-8、TNF-α、PGE2、ACTH、CRH、Vm、Vs、Vd、PI水平及临床疗效与并发症发生率,采用t检验、秩和检验、χ^(2)检验进行统计分析。结果术后第14天,观察组的IL-6、IL-8、TNF-α、PGE2、ACTH、CRH分别为(8.69±1.08)ng/L、(9.51±0.94)ng/L、(0.79±0.26)ng/L、(256.38±21.33)ng/L、(34.25±14.35)ng/L、(28.25±3.08)mg/L,均低于对照组[(10.38±3.74)ng/L、(12.35±2.70)ng/L、(1.00±0.35)ng/L、(271.35±34.89)ng/L、(41.26±10.78)ng/L、(30.24±4.78)mg/L];观察组Vm、Vs水平为(50.02±4.76)cm/s、(88.21±3.78)cm/s,均高于对照组[(47.25±3.99)cm/s、(85.79±3.02)cm/s];Vd、PI为(44.39±5.79)cm/s、0.92±0.04,均低于对照组[(47.20±3.17)cm/s、0.95±0.03];差异均有统计学意义(均P<0.05)。观察组治疗有效率为98.04%(50/51),对照组为82.98%(39/47),差异有统计学意义(P<0.05)。术后14 d内,观察组并发症发生率为5.88%(3/51),对照组为23.40%(11/47),差异有统计学意义(P<0.05)。结论血管内介入栓塞术可降低脑动脉瘤患者的炎症因子水平,缓解术后应激,改善脑血管状态,并提升临床治疗效果,减少并发症的发生概率。Objective To analyze the effects of endovascular interventional embolization on serum inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),and tumour-necrosis factor-α(TNF-α)],oxidative stress[prostaglandin E2(PGE2),corticotropin(ACTH),and corticotropin releasing hormone(CRH)],and cerebrovascular status[mean flow velocity(Vm),middle cerebral artery systolic peak velocity(Vs),end-diastolic flow velocity(Vd),and beat index(PI)]in patients with cerebral aneurysm.Methods This was a retrospective study.Ninety-eight patients with cerebral aneurysm treated at Yangling Demonstration Zone Hospital from July 2021 to December 2023 were selected.The 47 patients treated with craniotomy were set as a control group,including 26 men and 21 women who were(49.20±2.01)years old;the 51 patients treated with endovascular interventional embolization were set as an observation group,including 31 men and 20 women who were(50.98±2.40)years old.The levels of IL-6,IL-8,TNF-α,PGE 2,ACTH,and CRH,Vm,Vs,Vd,PI,clinical efficacies,and incidence rates of complications were compared between the two groups.t test,rank sum test,andχ^(2) test were used for the statistical analysis.Results On the 14th day after the surgery,the levels of IL-6,IL-8,TNF-α,PGE2,ACTH,and CRH in the observation group were lower than those in the control group[(8.69±1.08)ng/L vs.(10.38±3.74)ng/L,(9.51±0.94)ng/L vs.(12.35±2.70)ng/L,(0.79±0.26)ng/L vs.(1.00±0.35)ng/L,(256.38±21.33)ng/L vs.(271.35±34.89)ng/L,(34.25±14.35)ng/L vs.(41.26±10.78)ng/L,and(28.25±3.08)mg/L vs.(30.24±4.78)mg/L],with statistical differences(all P<0.05).The Vm,Vs,Vd,and PI in the observation group were better than those in the control group[(50.02±4.76)cm/s vs.(47.25±3.99)cm/s,(88.21±3.78)cm/s vs.(85.79±3.02)cm/s,(44.39±5.79)cm/s vs.(47.20±3.17)cm/s,and 0.92±0.04 vs.0.95±0.03],with statistical differences(all P<0.05).The effective rate in the observation group was higher than that in the control group[98.04%(50/51)vs.82.98%(39/47)],with a statistical difference(P<0.05).

关 键 词：炎症因子 应激反应 脑血管状态 脑动脉瘤 血管内介入栓塞术 

分 类 号：R743[医药卫生—神经病学与精神病学]