颅内动脉瘤患者介入术后血Ang-1 MMP-9 MCP-1水平变化与脑血管痉挛发生的关系  

Relationship between serum Ang-1,MMP-9 and MCP-1 changes and cerebrovascular spasm in patients with intracranial aneurysms after interventional surgery

作　　者：蒲蓉 周龙 向春晖 PU Rong;ZHOU Long;XIANG Chunhui(The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]恩施土家族苗族自治州中心医院,湖北恩施445000

出　　处：《中国实用神经疾病杂志》2025年第2期197-201,共5页Chinese Journal of Practical Nervous Diseases

基　　金：2023年恩施州“启航专项”科技计划项目(编号:D20230077)。

摘　　要：目的对颅内动脉瘤患者介入术后血清血管生成素-1(Ang-1)、基质金属蛋白酶-9(MMP-9)、单核细胞趋化蛋白-1(MCP-1)水平变化进行观察,并分析血清指标变化与脑血管痉挛(CVS)发生的关系。方法选取2022-01—2024-01恩施土家族苗族自治州中心医院收治的120例颅内动脉瘤患者为研究对象,均行介入栓塞术治疗,根据术后3~5 d是否发生CVS分为CVS组(n=47)和非CVS组(n=73),于术前、术后3 d分别检测患者血清Ang-1、MMP-9、MCP-1水平,比较2组患者血清指标水平差异,ROC曲线分析血清指标预测CVS发生的价值,并观察CVS不同严重程度间血清指标水平差异,分析血清指标与CVS不同严重程度相关性。结果术后,CVS组血清Ang-1水平低于非CSV组,血清MMP-9、MCP-1水平均高于非CSV组(P<0.05)。血清Ang-1、MMP-9、MCP-1均具有预测CSV发生的价值(AUC=0.655、0.915、0.785,P<0.05)。轻度CSV组患者术后血清Ang-1水平均高于中度CSV组和重度CSV组,MMP-9水平均低于中度CSV组、重度CSV组(P<0.05)。CSV患者脑血管直径缩短程度均与血清Ang-1、MMP-9、MCP-1水平有相关性(r=-0.660,0.352,0.575,P<0.05)。结论颅内动脉瘤患者介入术后CVS发生率较高,术后血清Ang-1、MMP-9、MCP-1水平变化与CVS发生发展有关。Objective To observe the changes of serum angiopoietin-1(Ang-1),matrix metalloproteinase-9(MMP-9)and monocyte chemotactic protein-1(MCP-1)in patients with intracranial aneurysms after interventional surgery,and to analyze the relationship between the above changes and cerebrovascular spasm(CVS).Methods A total of 120 patients with intracranial aneurysms undergoing interventional embolization in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture between January 2022 and January 2024 were enrolled as the research objects.According to presence or absence of CVS within 3-5 d after surgery,they were divided into CVS group(n=47)and non-CVS group(n=73).Before and at 3 d after surgery,the levels of serum Ang-1,MMP-9 and MCP-1 were detected,and the differences in the above serum indexes between the two groups were compared.The predictive value of Ang-1,MMP-9 and MCP-1 for CVS was analyzed by ROC curves,and the differences in the above serum indexes among patients with different severity of CVS were observed.The correlation between serum indexes and CVS severity was analyzed.Results After surgery,the level of serum Ang-1 in the CVS group was lower than that in the non-CSV group,while the levels of serum MMP-9 and MCP-1 were higher than those in the non-CSV group(P<0.05).Serum Ang-1,MMP-9 and MCP-1 were all of predictive value for CSV(AUC=0.655,0.915,0.785,respectively,P<0.05).After surgery,the level of serum Ang-1 in the mild CSV group was higher than that in the moderate and severe CSV groups,while the levels of MMP-9 and MCP-1 were lower than those in the moderate and severe CSV groups(P<0.05).The shortening degree of cerebrovascular diameter was correlated with serum Ang-1,MMP-9 and MCP-1(r=-0.660,0.352,0.575,respectively,P<0.05).Conclusion The incidence of CVS is higher in patients with intracranial aneurysms after interventional surgery,and postoperative changes of serum Ang-1,MMP-9 and MCP-1 are related to the occurrence and development of CVS.

关 键 词：颅内动脉瘤 介入栓塞术 脑血管痉挛 血管生成素-1 基质金属蛋白酶-9 单核细胞趋化蛋白-1 血清 

分 类 号：R739.41[医药卫生—肿瘤]