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通过微导管取样研究动脉瘤的局部代谢变化。

Study the local metabolic changes of aneurysms through microcatheter sampling.

机构信息

Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

Brain Research Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

Sci Rep. 2024 Aug 22;14(1):19552. doi: 10.1038/s41598-024-70309-6.

Abstract

Intracranial aneurysm is the primary cause of nontraumatic subarachnoid hemorrhage. To assess aneurysm metabolism, we present a method of intra-operatively collecting blood samples from the aneurysm neck, as well as the proximal and distal responsible vessels, using microcatheters. Through these paired comparisons, we can eliminate the interpatient variation usually observed in plasma samples taken from the peripheral vein. We utilized 39 plasma samples from 13 intracranial patients to characterize the metabolite profiles using untargeted liquid chromatography-mass spectrometry. Our findings revealed that L-tyrosine is upregulated at relatively high levels at the aneurysm neck than the proximal and distal aneurysm, whereas phenylpyruvic acid, L-cystine, and L-ornithine are downregulated. Based on this, there was also a significant decrease in arginine within small aneurysm of the internal carotid artery. The 6-month follow-up indicated that patients who experienced good recovery had lower levels of biliverdin, bilirubin, and metabolites of coenzyme Q within the aneurysm. In conclusion, our investigation provides a comprehensive overview of plasma metabolites in patients with intracranial aneurysms, shedding light on potential pathogenetic mechanisms in unruptured intracranial aneurysms. Moreover, the study proposes innovative ideas for establishing postoperative follow-up timelines for flow diverter devices.

摘要

颅内动脉瘤是蛛网膜下腔出血的主要原因。为了评估动脉瘤的代谢情况,我们提出了一种使用微导管从瘤颈、近端和远端责任血管采集血液样本的方法。通过这些配对比较,我们可以消除从外周静脉采集的血浆样本中通常观察到的个体间变异。我们使用来自 13 名颅内患者的 39 个血浆样本,通过非靶向液相色谱-质谱法对代谢物图谱进行了表征。我们的研究结果表明,L-酪氨酸在瘤颈处的水平相对较高,高于近端和远端的动脉瘤,而苯丙酮酸、L-胱氨酸和 L-鸟氨酸则下调。基于此,颈内动脉小动脉瘤内的精氨酸水平也显著降低。6 个月的随访表明,恢复良好的患者瘤内的胆红素、胆绿素和辅酶 Q 代谢物水平较低。总之,我们的研究提供了颅内动脉瘤患者血浆代谢物的全面概述,揭示了未破裂颅内动脉瘤中的潜在发病机制。此外,该研究为建立血流导向装置术后随访时间表提供了创新思路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f36a/11341698/1a64aa5bdd92/41598_2024_70309_Fig1_HTML.jpg

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