摘要
目的:探讨显微外科夹闭与血管内介入栓塞(TACE)治疗动脉瘤性蛛网膜下腔出血(ASAH)的疗效及其对血清血管相关因子的影响。方法:将149例ASAH患者按治疗方式不同分为观察组(n=78)及对照组(n=71);对照组行显微外科夹闭治疗,观察组行TACE治疗。比较两种不同治疗方式疗效及对血清高迁移率族蛋白1(HMGB1)、基质金属蛋白酶-9(MMP-9)、内皮素-1(ET-1)、血管内皮生长因子(VEGF)及血清中可溶性细胞间黏附因子-1(sICM-1)、可溶性血管细胞黏附因子-1(sVCAM-1)、血清类胰岛素样生长因子1(IGF-1)水平的影响。结果:观察组的疗效高于对照组(70.51%vs.50.70%,P<0.05)。治疗后,观察组HMGB1、MMP-9、ET-1、VEGF、sVCAM-1、IGF-1、sICM-1均低于对照组(P<0.05);观察组脑血管痉挛及颅内感染并发症发生率均低于对照组(P<0.05)。结论:TACE在ASAH中治疗效果优于显微镜外科夹闭,能有效降低对HMGB1、MMP-9、ET-1、VEGF、sICM-1、sVCAM-1、IGF-1等血清相关因子的影响。
Objective:To investigate the therapeutic effects of microsurgical clipping and endovascular interventional embolization(TACE)in the treatment of aneurysmal subarachnoid hemorrhage(ASAH),and the influence on serum factors.Methods:149 patients with ASAH were selected as research subjects,and divided into observation group(n=78)and control group(n=71)according to different treatment methods.Patients in the control group were treated with microsurgical clipping,and those in the observation group were treated with TACE.Therapeutic effects,levels of serum high mobility group box 1(HMGB1),matrix metalloproteinase-9(MMP-9),endothelin-1(ET-1),vascular endothelial growth factor(VEGF),soluble intercellular adhesion molecule-1(sICM-1),soluble vascular cell adhesion molecule-1(sVCAM-1),and insulin-like growth factor-1(IGF-1)were compared between the two groups.Results:The curative effect of the observation group was higher than that of the control group(70.51%vs.50.70%,P<0.05).After treatment,HMGB1,MMP-9,serum ET-1,VEGF,sVCAM-1,IGF-1 and sICM-1 were significantly lower in the observation group than in the control group(P<0.05).The incidences of complications like cerebral vasospasm and intracranial infection were significantly lower in the observation group than in the control group(P<0.05).Conclusion:TACE is more effective than microsurgical clipping in the treatment of ASAH,and can effectively reduce the effects on serum related factors such as HMGB1,MMP-9,ET-1,VEGF,sicm-1,sVCAM-1 and IGF-1.
作者
周长清
刘浩
张德明
石超
刁正文
刘俊
ZHOU Chang-qing;LIU Hao;ZHANG De-ming;SHI Chao;DIAO Zheng-wen;LIU Jun(Department of Surgery,Ya an Hospital of Traditional Chinese Medicine,Ya an 625000;Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041;Department of Neurosurgery,Ya an People's Hospital,Ya an 625000;Department of Surgery,Tianquan County People's Hospital,Ya an 625000,Sichuan,China)
出处
《川北医学院学报》
CAS
2022年第2期162-165,共4页
Journal of North Sichuan Medical College
基金
四川省科技厅国际合作项目(2020YFH0096)。
