Smart Mask技术辅助弹簧圈栓塞治疗脑动脉瘤效果及对外周血CD4^+/CD8^+的影响

Effect of Smart Mask assisted coil embolization in the treatment of cerebral aneurysms and its influence on peripheral blood CD4^+/CD8^+

目的探讨Smart Mask技术辅助弹簧圈栓塞治疗脑动脉瘤效果及对外周血CD4^+/CD8^+的影响。方法采用回顾性研究方法,选取2016年6月至2018年6月收治的92例脑动脉瘤患者为对象,患者均采取常规治疗,行Smart Mask技术辅助弹簧圈栓塞术的46例为研究组,行单纯弹簧圈栓塞术的46例为对照组。观察两组栓塞效果、手术情况(手术时间、X线曝光量、对比剂用量、出血量)、并发症,对比术前、术后1、3、5 d血清炎性应激指标[白细胞介素(IL)-6、皮质醇(Cor)、血管紧张素(AT-Ⅱ)]及外周血CD4^+/CD8^+、CD8^+、CD4^+水平,并于术后6、12个月随访两组复发率及生存率。结果(1)栓塞效果:研究组栓塞效果优于对照组(u=2.014,P<0.05);(2)手术情况:研究组手术时间短于对照组,X线曝光量、出血量、对比剂用量少于对照组(P均<0.01);(3)炎性应激指标:术后1、3、5 d研究组血清IL-6、Cor、AT-Ⅱ水平低于对照组(P<0.05,P<0.01);(4)外周血CD4^+/CD8^+、CD8^+、CD4^+:术后1、3、5 d研究组外周血CD4^+/CD8^+、CD4^+水平高于对照组,CD8^+水平低于对照组(P<0.05,P<0.01);(5)并发症:研究组并发症发生率4.34%低于对照组的21.73%(P<0.05);(6)预后:研究组失访4例,对照组失访5例,术后12个月研究组复发率7.14%低于对照组的29.27%(P<0.01)。结论Smart Mask技术辅助弹簧圈栓塞治疗脑动脉瘤,可改善手术情况,减少并发症,提高栓塞效果,降低复发率,且对炎性应激反应及外周血CD4^+/CD8^+水平影响较小。

Objective To investigate the effect of Smart Mask assisted coil embolization in the treatment of cerebral aneurysms and its influence of peripheral blood CD4^+/CD8^+.Methods A retrospective study was conducted in 92 patients with cerebral aneurysms from June 2016 to June 2018.All patients were treated with conventional treatment.46 patients underwent Smart Mask assisted coil embolization as the study group,and 46 patients with simple coil embolization as the control group.The embolization effect,operation condition(operation time,amount of X-ray exposure,contrast agent dosage,bleeding volume)and complications of the two groups were observed.The indexes of inflammatory stress[Interleukin(IL)-6,Cortisol(Cor),Angiotensin(AT-Ⅱ)]and peripheral blood CD4^+/CD8^+,CD8^+,CD4^+were compared before and 1-,3-and 5-day after operation.The recurrence rate and survival rate of the two groups were followed up at 6 and 12 months after operation.Results The embolization effect of the study group was better than that of the control group(u=2.014,P<0.05).The operation time of the study group was shorter than that of the control group,and the amount of X-ray exposure,blood loss and contrast agent were less than those of the control group(all P<0.01).The levels of IL-6,Cor and AT-Ⅱin the peripheral blood of the study group were lower than those of the control group on the 1-,3-and 5-day after operation(P<0.05,P<0.01).The levels of CD4^+/CD8^+and CD4^+in peripheral blood of the study group were higher than those of the control group on the 1-,3-and 5-day after operation,while the level of CD8^+was lower than that of the control group(P<0.05,P<0.01).The incidence of complications in the study group was significantly lower than that in the control group(4.34%vs 21.73%,P<0.05).Four cases were lost in the study group,and 5 cases were lost in the control group.The recurrence rate of the study group was significantly lower than that of the control group(7.14%vs 29.27%,P<0.01).Conclusion Smart Mask assisted coil embolization can improve the surgical situation,reduce the complications,improve the embolization effect,reduce the recurrence rate,and has little effect on inflammatory stress response and peripheral blood CD4^+/CD8^+.