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目的 探讨血清神经丝轻链蛋白(neurofilament light chain protein, NFL)、趋化素水平与老年颅内动脉瘤未破裂患者介入术后并发脑缺血的关系。方法 前瞻性选择2020年1月至2024年1月江西省吉安市中心人民医院重症医学科收治的颅内动脉瘤未破裂患者258例，均接受支架辅助弹簧栓塞介入手术治疗，根据术后是否发生脑缺血将颅内动脉瘤未破裂患者分为脑缺血组(52例)和无脑缺血组(206例)。检测血清NFL、趋化素水平。采用多因素logistic回归分析影响术后脑缺血的危险因素。结果 脑缺血组置入支架数量3枚比例、动脉瘤直径、术前、手术开始10 min、术后24 h血清NFL、趋化素水平明显高于无脑缺血组，手术时间明显长于无脑缺血组，差异有统计学意义(P<0.05,P<0.01)。动脉瘤直径较大、手术时间过长、高NFL、高趋化素是颅内动脉瘤未破裂患者介入术后脑缺血的危险因素(P<0.05,P<0.01)。动脉瘤直径、手术时间、NFL、趋化素预测颅内动脉瘤未破裂患者介入术后脑缺血的曲线下面积分别为0.772、0.794、0.826、0.837,联合预测曲线下面积为0.920,明显高于各项指标单独预测(P<0.05)。结论 老年颅内动脉瘤未破裂患者血清NFL、趋化素水平增高与支架辅助弹簧栓塞介入术后脑缺血有关，可预测老年颅内动脉瘤未破裂患者支架辅助弹簧栓塞介入术后脑缺血风险。
Abstract：Objective To investigate the relationship of serum levels of neurofilament light chain protein(NFL) and chemerin with cerebral ischemia after interventional therapy in elderly patients with unruptured intracranial aneurysms.Methods A total of 258 patients with unruptured intracranial aneurysms undergoing stent-assisted coil embolization in our hospital from January 2020 to January 2024 were enrolled.They were divided into a cerebral ischemia group(52 cases) and a non-cerebral ischemia group(206 cases).The serum NFL and chemerin levels were detected.Multivariate logistic regression analysis was conducted to analyze the risk factors for cerebral ischemia in the patients after interventional surgery.Results The cerebral ischemia group had significantly higher ratio of implantation of 3 stents, larger diameter of aneurysms, increased levels of NFL and chemerin before operation, 10 min from the start of operation and 24 h after operation, and longer operation time than the non-cerebral ischemia group(P<0.05,P<0.01).Larger aneurysm diameter, longer operation time, and higher NFL and chemerin levels were the risk factors for cerebral ischemia in patients with unruptured intracranial aneurysm after interventional surgery(P<0.05,P<0.01).The AUC value of aneurysm diameter, operation time, NFL and chemerin, and combination of these indicators in predicting cerebral ischemia in patients with unruptured intracranial aneurysm after interventional surgery was 0.772,0.794,0.826,0.837,and 0.920,respectively, with that of the combination higher than that of each indicator alone(P<0.05).Conclusion For the elderly patients with unruptured intracranial aneurysms, the increases of serum NFL and chemerin levels are associated with cerebral ischemia after stent-assisted coil embolization, which can predict the risk of cerebral ischemia after interventional therapy.
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基本信息:
中图分类号:R743
引用信息:
[1]胡文平,李鹏辉,彭龙龙,等.两种血清标志物与老年颅内动脉瘤未破裂患者介入术后并发脑缺血的相关性研究[J].中华老年心脑血管病杂志,2025,27(08):1005-1009.
基金信息:
江西省卫生健康委科技计划项目(220228245)
2025-08-08
2025-08-08