颅内动脉瘤患者血清IL-6、Hcy、sFlt-1与夹闭术后发生脑血管痉挛的关系研究

摘要 目的：探究血清白介素-6（IL-6）、同型半胱氨酸（Hcy）和可溶性Fms样酪氨酸激酶1（sFlt-1）与颅内动脉瘤（IAs）患者夹闭术后发生脑血管痉挛（CVS）的关系。方法：选取2021年7月至2023年7月185例于徐州医科大学附属医院 行颅内动脉瘤夹闭术的患者作为研究对象，根据患者术后发生CVS情况分为非CVS组和CVS组。采用酶联免疫吸附法检测IL-6、Hcy和sFlt-1水平。多因素Logistic回归分析IAs夹闭术后发生CVS的危险因素，受试者特征曲线（ROC）分析血清IL-6、Hcy和sFlt-1对IAs夹闭术后发生CVS的预测价值。结果：IAs夹闭术后共有43例患者发生CVS，CVS发生率为23.24%。CVS组血清IL-6、Hcy和sFlt-1水平均明显高于非CVS组（均P＜0.05）。多因素Logistic回归分析显示血清IL-6、Hcy和sFlt-1升高，Hunt-Hess分级为II~III级、动脉瘤直径大和蛛网膜下腔出血次数≥2是IAs夹闭术后发生CVS的独立危险因素（P＜0.05）。ROC曲线结果显示血清IL-6、Hcy和sFlt-1联合预测IAs夹闭术后发生CVS的曲线下面积（AUC）0.939，高于血清IL-6、Hcy和sFlt-1单独预测的0.768、0.825、0.826。结论：IAs夹闭术后发生CVS患者血清IL-6、Hcy、sFlt-1水平均显著升高，且为术后发生CVS的独立危险因素。血清IL-6、Hcy、sFlt-1联合检测对IAs夹闭术后发生CVS有较高预测价值。

Study on the Relationship between Serum IL-6, Hcy, sFlt-1 and Cerebral Vasospasm after Clipping Operation in Patients with Intracranial Aneurysms

ABSTRACT Objective: To investigate the relationship between serum interleukin-6 (IL-6), homocysteine (Hcy) and soluble Fms-like tyrosine kinase 1 (sFlt-1) and cerebral vasospasm (CVS) after clipping operation in patients with intracranial aneurysms (IAs). Methods: 185 patients who underwent intracranial aneurysm clipping operation in the Affiliated Hospital of Xuzhou Medical University from July 2021 to July 2023 were selected as research objects, patients were divided into non-CVS group and CVS group according to the occurrence of CVS after operation. The levels of IL-6, Hcy and sFlt-1 were detected by enzyme-linked immunosorbent assay. The risk factors of CVS after IAs clipping operation were analyzed by multivariate Logistic regression, the predictive value of serum IL-6, Hcy and sFlt-1 for CVS after IAs clipping operation were analyzed by receiver operating characteristic (ROC) curve. Results: 43 patients had CVS after IAs clipping operation, and the incidence of CVS was 23.24%. The levels of serum IL-6, Hcy and sFlt-1 in CVS group were significantly higher than those in non-CVS group (all P<0.05). Multivariate Logistic regression analysis showed that elevated serum IL-6, Hcy and sFlt-1, Hunt-Hess grade II-III, large aneurysm diameter and subarachnoid hemorrhage times≥2 were independent risk factors for CVS after IAs clipping operation (P<0.05). ROC curve results showed that the area under the curve (AUC) of serum IL-6, Hcy and sFlt-1 in predicting CVS after IAs clipping operation was 0.939, which was higher than 0.768, 0.825 and 0.826 predicted by serum IL-6, Hcy and sFlt-1 alone. Conclusion: The levels of serum IL-6, Hcy and sFlt-1 in patients with CVS after IAs clipping operation are significantly increase, and they are independent risk factors for postoperative CVS. The combine detection of serum IL-6, Hcy and sFlt-1 has a high predictive value for CVS after IAs clipping operation.