PED支架辅助弹簧圈栓塞联合阿哌沙班在老年颅内动脉瘤患者的疗效及其对DFR、GMP140、P73水平的影响

Efficacy of PED stent-assisted coil embolization combined with Apixaban in elderly patients with intracranial aneurysm and its effect on DFR,GMP140,and P73 levels

目的 探讨Pipeline血流导向装置(pipeline embolization device,PED)支架辅助弹簧圈栓塞联合阿哌沙班在老年颅内动脉瘤患者的疗效及其对D-二聚体/纤维蛋白原(D-dimer fibrinogen ratio,DFR)、血小板α-颗粒膜蛋白(α-granule membrane protein-140,GMP140)、脑脊液p73蛋白表达水平的影响。方法 前瞻性选取2020年1月~2021年1月我院收治的老年颅内动脉瘤患者120例作为研究对象,以数字表法将其分为两组,各60例,对照组采用PED支架辅助弹簧圈栓塞治疗,观察组采用PED支架辅助弹簧圈栓塞结合阿哌沙班治疗,比较两组的疗效,DFR、GMP140、P73表达水平,围手术期的相关临床指标、预后以及并发症发生情况。结果 观察组的疗效显著高于对照组(P<0.05);治疗前两组的血清DFR、GMP140、P73水平均无显著差异(P>0.05),治疗后观察组的GMP140表达水平显著低于对照组(P<0.05),而血清DFR、P73蛋白表达水平显著高于对照组(P<0.05);观察组的临床指标显著高于对照组(P<0.05);观察组预后率显著高于对照组(P<0.05);观察组并发症发生率显著低于对照组(P>0.05)。结论 将PED支架辅1助弹簧圈栓塞与阿哌沙班联合应用于老年颅内动脉瘤治疗过程中,疗效确切,预后好,并发症少,同时DFR、GMP140、P73水平可作为诊断老年颅内动脉瘤的理想诊断标记物,值得在临床上推广应用。

Objective To investigate the efficacy of Pipeline embolization device(PED) stent-assisted coil embolization combined with apixaban in elderly patients with intracranial aneurysms and its effect on D-dimer/fibrinogen(DFR),plateletα-granule membrane protein(GMP140),cerebrospinal fluid p73 protein expression level.Methods Prospectively select 120 elderly patients with intracranial aneurysm admitted to our hospital from January 2020 to January2021 as the research objects.They were divided into two groups by number table method,60 cases in each group.The control group used PED stents Auxiliary coil embolization treatment.The observation group was treated with PED stent-assisted coil embolization combined with apixaban treatment.The curative effects of the two groups were compared,the expression levels of DFR,GMP140,and P73,the relevant clinical indicators,prognosis and complications during the perioperative period.Results The curative effect of the observation group was significantly higher than that of the control group(P<0.05);the serum DFR,GMP140 and P73 levels of the two groups before treatment were not significantly different(P>0.05),and the expression level of GMP140 in the observation group was significantly lower than that after treatment.The control group(P<0.05),while the serum DFR and P73 protein expression levels were significantly higher than those of the control group(P<0.05);the clinical indicators of the observation group were significantly higher than those of the control group(P<0.05);the prognosis rate of the observation group was significantly higher Control group(P<0.05);the incidence of complications in the observation group was significantly lower than that in the control group(P>0.05).Conclusion The combination of PED stent assisted 1-assisted coil embolization and apixaban in the treatment of elderly intracranial aneurysms has a definite effect,agood prognosis,and fewer complications.At the same time,DFR,GMP140,and P73 levels can be used as a diagnosis for elderly patients.Ideal diagnostic markers for internal aneurysms are worthy of clinical application.