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

doi:10.3760/cma.j.cn441417-20240924-04009

摘要/Abstract

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、χ²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。

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

Abstract:

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, and χ² 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). Within 14 d after the surgery, the incidence rate of complications in the observation group was lower than that in the control group [5.88% (3/51) vs. 23.40% (11/47)], with a statistical difference (P<0.05). Conclusion　Endovascular interventional embolization for patients with cerebral aneurysm can reduce their levels of inflammatory factors, effectively relieve their postoperative stress, improve their cerebrovascular status and the clinical treatment effect, and reduce the incidence rate of complications.

Key words:

Inflammatory factors, Stress response, Cerebrovascular state, Cerebral aneurysm, Endovascular interventional embolization

巨岩史波　杨德民.

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 [J]. 国际医药卫生导报, 2025, 31(4): 568-572.

Ju Yan, Shi Bo, Yang Demin.

Effects of endovascular interventional embolization on serum inflammatory factors, oxidative stress, and cerebrovascular status in patients with cerebral aneurysm [J]. International Medicine and Health Guidance News, 2025, 31(4): 568-572.

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