颅内动脉瘤破裂出血与巨噬细胞、载脂蛋白及弹力蛋白的相关性

Correlation of intracranial aneurysm rupture hemorrhage with macrophages,apolipoprotein and elastin

目的:探讨颅内动脉瘤破裂出血与巨噬细胞、载脂蛋白以及弹力蛋白的相关性,为临床诊治提供参考。方法:回顾性分析128例颅内动脉瘤患者的临床资料,根据出血情况分为出血组(n=32,颅内动脉瘤破裂出血)和未出血组(n=96,体检或检查偶然发现颅内动脉瘤,但未破裂)。采用单因素法分析比较两组患者的一般资料和血清弹力蛋白、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、金属基质蛋白-9(MMP-9)、载脂蛋白A-1(ApoA1)、载脂蛋白B(ApoB)等实验室指标差异;通过多因素Logistic回归分析,对颅内动脉瘤破裂出血的危险因素进行分析,并采用Pearson法对其相关性进行分析。结果:出血组患者的纤维蛋白原、ApoB、TNF-α、MMP-9以及弹力蛋白水平高于未出血组,ApoA1水平低于未出血组(P<0.05)。对上述具有统计学意义的指标进行多因素Logistic回归分析显示,ApoA1、ApoB、TNF-1、MMP-9、弹力蛋白以及发生脑动脉硬化是颅内动脉瘤破裂出血的独立危险因素(P<0.05)。经Pearson相关性分析,血清ApoB、TNF-α、MMP-9以及弹力蛋白水平与颅内动脉瘤破裂出血呈现正相关,血清ApoA1水平与颅内动脉瘤破裂出血呈现负相关(P<0.05)。结论:颅内动脉瘤破裂出血与巨噬细胞相关因子、ApoB及弹力蛋白水平呈现正相关,与ApoA1水平呈负相关,具有一定的临床应用价值。

Objective:To explore the correlation between intracranial aneurysm rupture hemorrhage and macrophages,apolipoprotein and elastin,and to provide reference for its clinical diagnosis and treatment.Methods:Clinical data of 128 patients with intracranial aneurysms were retrospectively analyzed.According to their bleeding situation,they were divided into two groups:the bleeding group(n=32,intracranial aneurysm rupture)and the non-bleeding group(n=96,intracranial aneurysm rupture was accidentally found by physical examination or examination).The general data of the two groups were compared with the differences of serum elastin,interleukin-18(IL-18),tumor necrosis factor-α(TNF-α),metal matrix protein-9(MMP-9),apolipoprotein a-1(ApoA1),apolipoprotein B(ApoB)and other laboratory indicators by single factor method.Multivariate Logistic regression analysis was used to analyze the risk factors of intracranial aneurysm rupture and hemorrhage,and Pearson method was used to analyze the correlation.Results:The levels of fibrinogen,ApoB,TNF-α,MMP-9 and elastin in the bleeding group were significantly higher than those in the non-bleeding group,and the levels of ApoA1 were significantly lower than those in the non-bleeding group(P<0.05).Multivariate Logistic regression analysis showed that ApoA1,ApoB,TNF-α,MMP-9,elastin and cerebral arteriosclerosis were independent risk factors for intracranial aneurysm rupture and hemorrhage(P<0.05).Pearson correlation analysis showed that serum ApoB,TNF-α,MMP-9 and elastin levels were positively correlated with intracranial aneurysm rupture and hemorrhage,while serum ApoA1 levels were negatively correlated with intracranial aneurysm rupture and hemorrhage(P<0.05).Conclusion:Intracranial aneurysm rupture bleeding is positively correlated with levels of macrophage-related factors,ApoB and elastin,and negatively correlated with levels of ApoA1,which has certain clinical application value.