颅内动脉瘤患者手术预后及其相关危险因素分析

Prognosis of patients with intracranial aneurysms and analysis of its related risk factors

目的 分析颅内动脉瘤患者手术预后的影响因素,并探讨各种危险因素及生物标志物的预测价值。方法 回顾性分析2019年10月-2023年10月本院收治的接受颅内动脉瘤手术治疗的122例患者的临床资料,根据手术预后将患者分为预后良好组(n=95)和预后不良组(n=27)两组。比较两组的各种人口统计学特征、动脉瘤特征、脂质特征、炎症生物标志物和术中参数。进行相关性分析、逻辑回归分析和受试者操作特征(ROC)分析,以评估危险因素对手术预后的预测价值。结果 人口统计学特征(年龄、BMI、吸烟史)、合并症(高血压、糖尿病)、动脉瘤特征(破裂史、动脉瘤大小)、脂质状况(总胆固醇、甘油三酯、高密度脂蛋白胆固醇)、炎性生物标志物(TNF-α、IL-8、ET-1、HIF-1α、MMP-9)、ASA分级和手术预后之间存在显著相关性。逻辑回归分析显示以上因素均为颅内动脉瘤患者手术预后的独立危险因素。ROC分析显示TNF-α是一种具有高度敏感性和特异性的潜在预后标志物(AUC=0.937)。结论 年龄、BMI、吸烟史、合并症、动脉瘤特征、脂质特征和炎症生物标志物是颅内动脉瘤患者手术预后的重要预测因素。TNF-α作为一种有前景的预后标志物,有指导治疗从而改善患者手术预后的潜力。

Objective To analyze the various factors affecting the surgical prognosis of patients with intracranial aneurysms and to explore the predictive value of various risk factors and biomarkers.Methods The clinical data of 122 patients who underwent surgical treatment for intracranial aneurysms from October 2019 to October 2023 were retrospectively analyzed.Patients were categorized into two groups based on surgical prognosis:good prognosis group(n=95)and poor prognosis group(n=27).Various demographic characteristics,aneurysm characteristics,lipid profiles,inflammatory biomarkers,and intraoperative parameters were compared between the two groups.Correlation analyses,logistic regression analyses,and receiver operating characteristic(ROC)analyses were performed to assess the predictive value of risk factors on surgical prognosis.Results Demographic characteristics(age,BMI,smoking history),comorbidities(hypertension,diabetes),aneurysm characteristics(rupture history,aneurysm size),lipid profile(total cholesterol,triglycerides,high-density lipoprotein cholesterol),inflammatory biomarkers(TNF-α,IL-8,ET-1,HIF-1α,MMP-9),ASA classification,and surgical prognosis showed a significant correlation.Logistic regression analysis showed that all of the above factors were independent risk factors for surgical prognosis in patients with intracranial aneurysms.ROC analysis showed that TNF-αwas a potential prognostic marker with high sensitivity and specificity(AUC=0.937)Conclusions Age,BMI,smoking history,comorbidities,aneurysm characteristics,lipid profile,and inflammatory biomarkers are important predictors of surgical prognosis in patients with intracranial aneurysms.TNF-α,as a promising prognostic marker,has the potential to guide treatment and thereby improve the surgical prognosis of patients.