1.河北北方学院附属第一医院神经外科,河北 张家口 075000
2.河北北方学院附属第一医院药学部,河北 张家口 075000
Published:25 December 2024,
Received:16 November 2023,
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曹兵,丁奇,柳永达等.血清sFlt-1、LTB4对颅内动脉瘤介入栓塞术后脑血管痉挛的预测价值[J].局解手术学杂志,2024,33(12):1062-1065.
CAO Bing,DING Qi,LIU Yong-da,et al.Predictive value of serum sFlt-1 and LTB4 for cerebral vasospasm after interventional embolization of intracranial aneurysms[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1062-1065.
曹兵,丁奇,柳永达等.血清sFlt-1、LTB4对颅内动脉瘤介入栓塞术后脑血管痉挛的预测价值[J].局解手术学杂志,2024,33(12):1062-1065. DOI: 10.11659/jjssx.11E023070.
CAO Bing,DING Qi,LIU Yong-da,et al.Predictive value of serum sFlt-1 and LTB4 for cerebral vasospasm after interventional embolization of intracranial aneurysms[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1062-1065. DOI: 10.11659/jjssx.11E023070.
目的
2
探讨颅内动脉瘤患者血清可溶性血管生长因子受体(sFlt-1)、白三烯B4(LTB4)对介入栓塞术后脑血管痉挛(CVS)的预测价值。
方法
2
选取2019年1月至2023年9月本院收治的98例颅内动脉瘤患者为观察组,依据术后3~5 d内是否发生CVS分为CVS组(32例)和无CVS组(66例);选取102例同期本院健康体检者作为对照组。采用酶联免疫吸附法检测血清sFlt-1、LTB4水平。采
用
Logistic
回归分析颅内动脉瘤介入栓塞术后CVS的影响因素。采用受试者工作特征(
ROC
)曲线分析血清sFlt-1、LTB4水平对颅内动脉瘤介入栓塞术后CVS的预测价值。
结果
2
观察组患者血清sFlt-1、LTB4水平均高于对照组,差异有统计学意义(
P
<
0.05)。CVS组患者血清sFlt-1、LTB4水平及术后血压波动范围≥30 mmHg、Hunt-Hess分级Ⅲ级比例均高于无CVS组,差异有统计学意义(
P
<
0.05)。sFlt-1(
OR
:2.985;95%
CI
:1.684~5.291)、LTB4(
OR
:2.868;95%
CI
:1.581~5.204)是颅内动脉瘤介入栓塞术后CVS的独立危险因素(
P
<
0.05)。sFlt-1、LTB4单独及联合预测颅内动脉瘤介入栓塞术后CVS的曲线下面积(
AUC
)分别为0.839、0.825、0.915,敏感度分别为84.44%、87.59%、81.36%,特异度分别为74.26%、75.87%、90.98%,两者联合的
AUC
高于sFlt-1、LTB4单独的
AUC
,差异均有统计学意义(
Z
=2.150、2.546,
P
<
0.05)。
结论
2
颅内动脉瘤介入栓塞术后CVS患者血清sFlt-1、LTB4水平升高,二者联合检测可作为预测CVS的重要指标。
Objective
2
To explore the predictive value of soluble fms-like tyrosine kinase-1 (sFlt-1) and leukotriene B4 (LTB4) in patients with intracranial aneurysms for cerebral vasospasm (CVS) after interventional embolization.
Methods
2
A total of 98 patients with intracranial aneurysms admitted to our hospital from January 2019 to September 2023 were regarded as the observation group,and were divided into the CVS group (32 cases) and the non CVS group (66 cases)according to whether CVS occurred or not within 3 to 5 days after surgery;102 healthy examinees in our hospital were selected as the control group. Enzyme-linked immunosorbent assay was used to detect serum levels of sFlt-1 and LTB4; the influencing factors for CVS after interventional embolization of intracranial aneurysms were analyzed by
Logistic
regression analysis;the predictive value of serum sFlt-1 and LTB4 levels for the occurrence of CVS after interventional embolization of intracranial aneurysms was analyzed by
receiver operating characteristic(ROC
) curve.
Results
2
The serum levels of sFlt-1 and LTB4 of patients in the observation group were obviously higher than those in the control group,and the differences were statistically significant (
P
<
0.05).The serum levels of sFlt-1 and LTB4,and the proportions of patients with postoperative blood pressure fluctuation range≥30 mmHg and Hunt-Hess grade Ⅲ in the CVS group were obviously higher than those in the non CVS group,and the differences were statistically significant (
P
<
0.05). SFlt-1 (
OR
:2.985;95%
CI
:1.684 to 5.291) and LTB4 (
OR
:2.868;95%
CI
:1.581 to 5.204) were the independent risk factors for CVS after interventional embolization of intracranial aneurysms (
P
<
0.05). The
area under the curve
(
AUC
) of sFlt-1 and LTB4 alone and in combination for predicting the occurrence of CVS after interventional embolization of intracranial aneurysms were 0.839,0.825,and 0.915,respectively,with sensitivity of 84.44%,87.59%,and 81.36%,and specificity of 74.26%,75.87%,and 90.98%,respectively.The
AUC
of the combination of the two was higher than those of sFlt-1 and LTB4 alone,and the differences were statistically significant (
Z
=2.150,2.546,
P
<
0.05).
Conclusion
2
The serum levels of sFlt-1 and LTB4 in patients with CVS after interventional embolization of intracranial aneurysms are increased,and the combination of the two can serve as the important indicators for predicting CVS.
颅内动脉瘤介入栓塞术脑血管痉挛可溶性血管生长因子受体白三烯B4
intracranial aneurysmsinterventional embolizationcerebral vasospasmsoluble fms-like tyrosine kinase-1leukotriene B4
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