血清白介素-15、白介素-17A水平与孤立性未破裂颅内动脉瘤破裂风险的相关性研究  

Correlation of serum interleukin-15 and interleukin-17A levels with the risk of rupture in isolated unruptured intracranial aneurysms

作　　者：谢洪伟 漆平强 王代桦 曾勇 殷滔 彭伟 曾义军 Xie Hongwei;Qi Pingqiang;Wang Daihua;Zeng Yong;Yin Tao;Peng Wei;Zeng Yijun(Department of Neurosurgery,The Third Affiliated Hospital of Chengdu Medical College,Pidu District People’s Hospital of Chengdu,Chengdu Sichuan 611730,China)

机构地区：[1]成都医学院第三附属医院(成都市郫都区人民医院)神经外科,四川成都611730

出　　处：《中国医刊》2025年第3期287-292,共6页Chinese Journal of Medicine

基　　金：四川省医学科研课题计划(S22019)。

摘　　要：目的探讨血清白介素-15(IL-15)、IL-17A水平与孤立性未破裂颅内动脉瘤(UIA)破裂风险的相关性。方法选取2022年3月至2024年4月成都市郫都区人民医院收治的孤立性UIA患者为研究对象,按UIA破裂风险不同将研究对象分为低风险组[颅内动脉瘤破裂风险(PHASES)评分为0~4分]和中高风险组(PHASES评分≥5分),对低风险组和中高风险组患者按照1∶1的比例进行倾向评分匹配,用于减少两组间基线特征的不平衡,匹配成功后每组各81例患者。比较分析两组患者的临床资料、血清细胞因子水平。采用多因素logistic回归方法分析UIA破裂存在中高风险的独立影响因素。采用受试者操作特征(ROC)曲线分析血清IL-15、IL-17A对UIA破裂存在中高风险的预测价值。结果中高风险组患者合并缺血性心脏病比例、动脉瘤直径、瘤颈宽、纵横比、体积比、表面积、体积、低剪切区、分叉部动脉瘤比例、动脉瘤形态不规则比例、脑部血流状态不稳定比例、生长调节致癌基因-α、IL-7、IL-15、IL-17A、血管内皮生长因子水平均高于低风险组,最小壁剪切应力低于低风险组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,纵横比、IL-15、IL-17A均是UIA破裂存在中高风险的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清IL-15、IL-17A预测UIA破裂存在中高风险的曲线下面积分别为0.744(95%CI 0.670~0.818)、0.735(95%CI 0.659~0.810)。结论高水平IL-15、IL-17A与孤立性UIA破裂存在中高风险显著相关,且对孤立性UIA破裂存在中高风险具有较好预测价值。Objective To investigate the correlation of serum interleukin-15(IL-15)and IL-17A levels with the risk of rupture in isolated unruptured intracranial aneurysm(UIA).Method Isolated UIA patients admitted to Pidu District People’s Hospital of Chengdu from March 2022 to April 2024 were selected as the study objects,and they were divided into low-risk group(PHASES score:0 to 4)and medium-high-risk group(PHASES score≥5)according to different UIA rupture risk,and propensity score matching was performed for patients in the low-risk group and the medium-high-risk group according to the ratio of 1∶1 to reduce the imbalance of baseline characteristics between the two groups,with 81 patients in each group.The clinical data and serum cytokine levels in the two groups were compared.Multivariate logistic regression method was used to analyze the independent influencing factors of the medium-high-risk of UIA rupture.The predictive value of serum IL-15 and IL-17A on the high medium-high-risk of UIA rupture was analyzed by ROC curve.Result Proportion of ischemic heart disease,aneurysm diameter,neck width,aspect ratio,volume ratio,surface area,volume,low shear zone,proportion of forked aneurysms,proportion of irregular aneurysm shape,proportion of unstable cerebral bloodflow state,growth-regulating oncogene-α,IL-7,IL-15,IL-17A,and vascular endothelial growth factor in the medium-high-risk group were all higher than those in the low-risk group,and the minimum wall shear stress was lower than that in the low-risk group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that aspect ratio,IL-15 and IL-17A were independent risk factors for the medium-high-risk of UIA rupture(P<0.05).ROC curve analysis results showed that the areas under the curve of serum IL-15 and IL-17A to predict the medium-high-risk of UIA rupture were 0.744(95%CI 0.670-0.818)and 0.735(95%CI 0.659-0.810).Conclusion High levels of IL-15 and IL-17A were significantly associated with the medium-high-ri

关 键 词：细胞因子 白介素-17A 白介素-15 未破裂颅内动脉瘤 破裂风险 

分 类 号：R739.41[医药卫生—肿瘤]