介入手术联合抗血小板药物治疗颅内动脉瘤的效果及对预后的影响研究

Effects of antiplatelet drug in treating intracranial aneurysm on neurological function, the level of serum sICAM-1 and prognosis after interventional surgery

摘要:

目的 探究介入手术后联合抗血小板药物颅内动脉瘤对神经功能、血清可溶性细胞间黏附分子（sICAM-1）水平及预后的影响。方法 按照随机数表法选取河南科技大学第一附属医院2020年6月至2022年6月接收诊治的98例颅内动脉瘤患者，分为观察组49例和对照组49例。两组均行颅内动脉瘤支架辅助栓塞术，对照组给予术后常规抗凝药物治疗，观察组给予抗血小板药物治疗。比较两组神经功能、血清黏附因子水平、术后并发症发生率。结果 治疗后，相比于对照组，观察组颅内动脉瘤患者的髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）、基质金属蛋白酶-9（MMP-9）均降低（P<0.05）；治疗后，相比于对照组，观察组血清sICAM-1与血管可溶性细胞黏附分子-1（sVCAM-1）水平均降低（P<0.05）；治疗后，观察组术后并发症总发生率为6.12%（3/49），对照组为20.41%（10/49）（P<0.05）。结论 介入手术后联合抗血小板药物治疗颅内动脉瘤在调整神经功能、血清黏附因子水平发挥了极为显著的作用，提升了神经功能，帮助消除了血栓形成引起的术后缺血性并发症，更可以帮助颅内动脉瘤征患者加速脑功能康复。

Abstract:

Objective To explore the effects of antiplatelet drug in treating intracranial aneurysm on neurological function, the level of serum sICAM-1 and prognosis after interventional surgery.Methods A total of 98 patients with cerebral aneurysm admitted to the First Affiliated Hospital of Henan University of Science & Technology from June 2020 to June 2022 were randomly divided into a test group of 49 cases and a matched group of 49 cases using a random number table method. Both groups underwent cerebral aneurysm stent-assisted embolization, and the patients in the control group were given routine anticoagulant therapy, while those in the observation group were given antiplatelet drug therapy. The nerve function, the levels of serum adhesion factor and postoperative complication rate were compared between the two groups.Results After treatment, compared with the control group, the levels of myelin basic protein (MBP), neuron specific enolase (NSE) and matrix metalloproteinase metalloproteinase-9 (MMP-9) in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in the observation group were lower than those in the control group (P<0.05). After treatment, the incidence of postoperative complications was 6.12% (3 cases/49 cases) in the observation group and 20.41% (10 cases/49 cases) in the control group (P<0.05).Conclusion The combined antiplatelet drug therapy after interventional surgery in cerebral aneurysm plays a very significant role in regulating nerve function and the levels of serum adhesion factor, and improving nerve function, it can help eliminate the ischemic complications caused by thrombosis and accelerate the recovery of brain function in cerebral aneurysm patients.