早期显微手术夹闭及血管内介入对颅内动脉瘤破裂出血患者炎症反应、神经功能及血清HIF-1α、MMP-9的影响

Effect of early microsurgery clipping and endovascular intervention on inflammatory response,neurological function and serum HIF-1 and MMP-9 in patients with intracranial aneurysm rupture and bleeding

目的:研讨早期显微手术夹闭及血管内介入对颅内动脉瘤破裂出血患者炎症反应、神经功能及血清缺氧诱导因子-1α(HIF-1α)、基质金属蛋白酶-9(MMP-9)的影响.方法:选择2019年6月~2021年6月本院收治的180例颅内动脉瘤破裂出血的患者作为研究对象,采用随机数字分组法将180例患者分为两组,观察组(98例)进行血管内介入治疗,对照组(82例)接受显微手术夹闭治疗,比较两组患者术前以及术后一周炎性因子(TNF-α、IL-6)、术前及术后两周神经功能缺损(NIHSS)、生活活动能力(BI)、血清HIF-1α、MMP-9、手术时间以及术中出血量.结果:术后1周两组患者炎性因子(TNF-α、IL-6)、血清HIF-1α、MMP-9均有所降低,且观察组下降更明显.术后两组患者NIHSS和BI均有所改善,且观察组优于对照组.两组患者手术中出血量观察组显著低于对照组,手术时间短于对照组.结论:早期显微手术夹闭及血管内介入治疗能够对患者炎性反应、HIF-1α、MMP-9均起到抑制作用,继而神经功能得以改善,且血管内介入效果更佳.

Objective Discuss the effects of early microsurgery clipping and endovascular intervention on inflammatory response,neurological function and serum hypoxia inducing factor-1(HIF-1)and matrix metalloproteinase-9(MMP-9)in pa-tients with intracranial aneurysm rupture and bleeding.Methods Select 180 patients with intracranial aneurysm rupture from June 2019 to June 2021,10,Randomized numerical grouping was used to divide 180 patients into two groups,The observation group(98 cases)performed endovascular interventional therapy,The control group(82 patients)received microsurgical clip-ping treatment,Comparing the inflammatory factors(TNF-α,IL-6)before surgery and one week after surgery between the two groups;Compare the neurological deficit(NIHSS)and life mobility(BI)before surgery and two weeks later;Serum HIF-1 and MMP-9 were compared between the two groups;The operation time and the intraoperative amount of bleeding between the two groups were recorded.Results One week after operation,the levels of inflammatory factors(TNF-α,IL-6),serum HIF-1αand MMP-9 in both groups decreased,and the decrease was more obvious in the observation group.NIHSS and BI were improved in both groups after operation,and the observation group was better than the control group.The amount of bleeding in the ob-servation group was significantly lower than that in the control group,and the operation time was shorter than that in the control group.Conclusion Early microsurgery clipping and endovascular intervention can inhibit the inflammatory response,HIF-1,MMP-9,and then improve the nerve function,and have better endovascular intervention.