介入栓塞术治疗颅内动脉瘤的疗效及对患者血清NF-κB、ICAM-1、MMP-9水平的影响

Effect of interventional embolization on serum levels of NF-κB,ICAM-1 and MMP-9 in patients with intracranial aneurysms

目的观察介入栓塞术治疗颅内动脉瘤的疗效及对患者血清核因子-κB(NF-κB)、细胞间黏附分子-1(ICAM-1)及基质金属蛋白酶-9(MMP-9)水平的影响。方法选择2016年3月—2019年12月毕节市第一人民医院神经外科收治的颅内动脉瘤患者116例作为研究对象,按照随机数字表法分为对照组和观察组各58例。对照组患者给予开颅夹闭术治疗,观察组患者给予介入栓塞术治疗,术后随访3个月。比较2组患者临床疗效、围手术期指标,治疗前后血清NF-κB、ICAM-1、MMP-9、神经功能、生活质量水平变化及术后并发症。结果观察组临床疗效明显优于对照组(Z=3.156,P=0.001),术中出血量、手术时间、住院时间均显著低于/短于对照组(t/P=50.078/<0.001、28.886/<0.001、11.866/<0.001)。与治疗前比较,治疗后2组患者血清NF-κB、ICAM-1、MMP-9水平及神经功能评分均明显降低,生活活动能力评分明显升高,且观察组改善较对照组更显著(t/P=19.412/<0.001、10.702/<0.001、17.417/<0.001、5.639/<0.001、10.382/<0.001)。观察组并发症发生率明显低于对照组(χ^2/P=4.921/0.027)。结论介入栓塞术可以有效降低颅内动脉瘤患者神经功能损伤,提高生活活动能力,改善其血清NF-κB、ICAM-1及MMP-9水平,效果显著。

Objective To observe the effect of interventional embolization in the treatment of intracranial aneurysms and its effect on serum levels of nuclear factor kappa B(NF-κB),intercellular adhesion molecule-1(ICAM-1)and matrix metalloproteinase-9(MMP-9).Methods One hundred and sixteen patients with intracranial aneurysms admitted to the Department of Neurosurgery of the First People's Hospital of Bijie City from March 2016 to December 2019 were selected as the research objects,and they were randomly divided into the control group and the observation group with 58 cases in each group.The control group was treated with craniotomy and clipping,and the observation group was treated with interventional embolization.The patients were followed up for 3 months.The clinical efficacy,perioperative indicators,changes of serum NF-κB,ICAM-1,MMP-9,nerve function,quality of life and postoperative complications were compared between the two groups.Results The clinical efficacy of the observation group was significantly higher than that of the control group(Z=3.156,P=0.001),and intraoperative blood loss,operation time,and hospital stay were lower/shorter than that of the control group(t/P=50.078/<0.001,28.886/<0.001,11.866/<0.001).Compared with before treatment,after treatment,the serum NF-κB,ICAM-1,MMP-9 levels and neurological function scores of the two groups of patients were significantly reduced,and the life activity score was significantly increased,and the observation group improved more significantly than the control group(t/P=19.412/<0.001,10.702/<0.001,17.417/<0.001,5.639/<0.001,10.382/<0.001).The incidence of complications in the observation group was significantly lower than that in the control group(χ^2/P=4.921/0.027).Conclusion Interventional embolization can effectively reduce the nerve function injury,improve the activity of life,and improve the serum levels of NF-κB,ICAM-1 and MMP-9 in patients with intracranial aneurysms.