血清COL1A1/2表达与颅内动脉瘤破裂的相关性研究

Correlation between expressions of serum COL1A1/2 and intracranial aneurysm rupture

目的检测颅内动脉瘤(IA)患者血清Ⅰ型胶原蛋白α1链(COL1A1)、Ⅰ型胶原蛋白α2链(COL1A2)的表达水平,探讨其与动脉瘤破裂的相关性。方法以我院收治的110例IA患者为IA组,另选取同期在我院进行健康体检的志愿者100例为对照组。采用ELISA法检测血清COL1A1、COL1A2表达水平。根据有无动脉瘤破裂将IA患者分为破裂组(n=66)与未破裂组(n=44),比较2组患者临床资料及血清COL1A1、COL1A2表达水平。比较不同Hunt-Hess分级患者血清COL1A1、COL1A2表达水平。采用多因素Logistic回归分析影响IA患者动脉瘤破裂的危险因素。采用受试者工作特征(ROC)曲线评估血清COL1A1、COL1A2对IA患者动脉瘤破裂的预测价值。采用Spearman相关性分析破裂组患者血清COL1A1、COL1A2与Hunt-Hess分级的相关性。结果IA组患者血清COL1A1、COL1A2表达水平均明显高于对照组(P<0.05)。破裂组患者高血压、糖尿病、高脂血症、动脉瘤直径>10 mm例数及COL1A1、COL1A2表达水平均明显多/高于未破裂组(P<0.05)。Hunt-Hess分级Ⅲ~Ⅳ级患者血清COL1A1、COL1A2表达水平明显高于Ⅰ~Ⅱ级患者(P<0.05)。破裂组患者血清COL1A1、COL1A2表达水平与Hunt-Hess分级均呈正相关(r=0.562、0.414,P<0.05)。多因素Logistic回归分析显示,高血压,糖尿病,动脉瘤直径>10 mm,COL1A1、COL1A2表达水平升高是IA患者动脉瘤破裂的危险因素(P<0.05)。血清COL1A1、COL1A2联合预测IA患者动脉瘤破裂的曲线下面积(AUC)显著大于COL1A1单独预测(Z=1.905,P=0.028)及COL1A2单独预测(Z=1.754,P=0.040)。结论COL1A1、COL1A2表达水平升高是IA患者动脉瘤破裂的危险因素,二者联合预测IA患者动脉瘤破裂有一定的临床价值。

Objective To detect the levels of serum collagen typeⅠalpha 1 chain(COL1A1)and collagen typeⅠalpha 2 chain(COL1A2)in patients with intracranial aneurysm(IA),and explore their correlations with aneurysm rupture.Methods A total of 110 IA patients admitted to our hospital were regarded as the IA group and another 100 volunteers who underwent physical examination in our hospital were regarded as the control group.The expression levels of serum COL1A1 and COL1A2 were detected by ELISA.The IA patients were divided into the ruptured group(n=66)and unruptured group(n=44)according to the presence or absence of aneurysm rupture,and the clinical data and expression levels of serum COL1A1 and COL1A2 were compared between the two groups.The expression levels of serum COL1A1 and COL1A2 in patients with different Hunt-Hess grades were compared.The risk factors of aneurysm rupture in patients with IA were analyzed by multivariate Logistic regression analysis.The predictive value of serum COL1A1 and COL1A2 for aneurysm rupture in patients with IA were evaluated by receiver operating characteristic(ROC)curve.The correlation of serum COL1A1 and COL1A2 with Hunt�Hess grade for patients in rupture group was analyzed by Spearman correlation analysis.Results The expression levels of serum COL1A1 and COL1A2 for patients in the IA group were significantly higher than those in the control group(P<0.05).The number of patients with hypertension,diabetes mellitus,hyperlipidemia,aneurysm diameter>10 mm,and the expression levels of serum COL1A1 and COL1A2 in the rupture group were significantly more/higher than those in the unruptured group(P<0.05).The expression levels of serum COL1A1 and COL1A2 in patients with Hunt-Hess grades fromⅢtoⅣwere significantly higher than those in patients with grades fromⅠtoⅡ(P<0.05).The expression levels of serum COL1A1 and COL1A2 for patients in the rupture group were positively correlated with Hunt-Hess grade(r=0.562,0.414,P<0.05).Multivariate Logistic regression analysis showed that hypertension,diabetes mellitus,aneurysm diameter>10 mm,and increased expression levels of COL1A1 and COL1A2 were risk factors for aneurysm rupture in IA patients(P<0.05).The area under the curve(AUC)of aneurysm rupture predicted by serum COL1A1 and COL1A2 together was significantly higher than that predicted by COL1A1 alone(Z=1.905,P=0.028)and COL1A2 alone(Z=1.754,P=0.040).Conclusion The increased expression levels of serum COL1A1 and COL1A2 are risk factors for aneurysm rupture in patients with IA,and their combined prediction of aneurysm rupture in IA patients has certain clinical value.