Nakatogawa Hirokazu, Hokamura Kazuya, Nomura Ryota, Nakano Kazuhiko, Umemura Kazuo, Morita Akio, Homma Yoichiro, Tanaka Tokutaro
Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Department of Medical Education Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Cerebrovasc Dis. 2024;53(6):722-728. doi: 10.1159/000536203. Epub 2024 Jan 12.
Streptococcus mutans (SM) with the collagen-binding protein Cnm is a unique member of the oral resident flora because it causes hemorrhagic vascular disorders. In the multicenter study, we examined the relationship between Cnm-positive SM (CP-SM) and intracranial aneurysm (IA) rupture, which remains unknown.
Between May 2013 and June 2018, we collected whole saliva samples from 431 patients with ruptured IAs (RIAs) and 470 patients with unruptured IAs (UIAs). Data were collected on age, sex, smoking and drinking habits, family history of subarachnoid hemorrhage, aneurysm size, number of teeth, and comorbidities of lifestyle disease.
There was no difference in the positivity rate of patients with CP-SM between the patients with RIAs (17.2%) and those with UIAs (19.4%). In subanalysis, the rate of positivity for CP-SM was significantly higher in all IAs <5 mm than in those ≥10 mm in diameter (p = 0.0304). In the entire cohort, the rate of positivity for CP-SM was lower in larger aneurysms than in smaller aneurysms (p = 0.0393).
CP-SM was not involved in the rupture of UIAs. In the subanalysis, the possibility of its involvement in the formation of vulnerable aneurysms remained.
携带有胶原结合蛋白Cnm的变形链球菌（SM）是口腔常驻菌群中的独特成员，因为它会引发出血性血管疾病。在这项多中心研究中，我们调查了Cnm阳性变形链球菌（CP-SM）与颅内动脉瘤（IA）破裂之间的关系，而这一关系尚不明确。
在2013年5月至2018年6月期间，我们收集了431例颅内动脉瘤破裂患者（RIA）和470例未破裂颅内动脉瘤患者（UIA）的全唾液样本。收集的数据包括年龄、性别、吸烟和饮酒习惯、蛛网膜下腔出血家族史、动脉瘤大小、牙齿数量以及生活方式疾病的合并症。
RIA患者中CP-SM阳性率（17.2%）与UIA患者中CP-SM阳性率（19.4%）无差异。在亚分析中，所有直径<5 mm的IA中CP-SM阳性率显著高于直径≥10 mm的IA（p = 0.0304）。在整个队列中，较大动脉瘤中CP-SM阳性率低于较小动脉瘤（p = 0.0393）。
CP-SM与UIA破裂无关。在亚分析中，其参与形成易损动脉瘤的可能性仍然存在。
