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炎症生物标志物作为支架辅助弹簧圈栓塞术后颅内动脉瘤复发的预后指标

Inflammatory Biomarkers as Prognostic Indicators for Intracranial Aneurysm Recurrence After Stent-Assisted Coil Embolization.

作者信息

Wei Jie, Lin Jinghui, Zhang Junjun, Dai Zifeng, Zeng Yiyong, Li Xianru, Li Yong, Zhang Jianfei, Lin Zhiqing, Zhou Shengjun

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, China.

出版信息

Immun Inflamm Dis. 2025 Jul;13(7):e70240. doi: 10.1002/iid3.70240.

Abstract

BACKGROUND

The reappearance of intracranial aneurysms (IAs) after undergoing stent-assisted coil embolization (SACE) is a significant issue in clinical practice. In this study, we analyzed blood regulatory T-cell counts and plasma cytokine levels to assess the extent of systemic inflammation and investigate their potential association with the recurrence of IAs undergoing SACE.

METHODS

A total of 189 individuals with 220 unruptured IAs were included in a retrospective study, with participants categorized into groups of occlusion and recurrence according to the Raymond-Roy Scale. Initially, a univariate analysis was used to identify distinctions among clinical data, morphological parameters, and preoperative plasma cytokine levels. A logistic regression model was built using variables with a significance level of p < 0.05, and the specificity and sensitivity of the chosen parameters were assessed through graphical and statistical analysis using receiver operating characteristic (ROC) curve techniques.

RESULTS

In the group with recurrence, the plasma concentrations of IL-2, IL-10, IL-17, and IFN-γ were notably elevated compared to the occlusion group. Based on binary logistic regression analysis, it was found that the levels of IL-10 (odds ratio = 1.24, 95% CI = 1.06-1.46, p = 0.008), IL-17 (odds ratio = 1.45, 95% CI = 1.17-1.82, p < 0.001), and INF-γ (odds ratio = 1.28, 95% CI = 1.07-1.54, p = 0.007) were determined to be crucial independent indicators for the recurrence of IAs. The highest predictive accuracy recurrence risk, with an area under the curve of 0.761, was achieved through the combination of IL-2, IL-10, IL-17, and INF-γ.

CONCLUSIONS

Findings reveal indicate that elevated levels of plasma IL-2, IL-10, IL-17, and IFN-γ are consistently present in recurrent IAs, implying that the initial inflammatory levels in the body are a major contributor to the recurrence of IAs following SACE. The combination of IL-2, IL-10, IL-17, and IFN-γ may assist in predicting the likelihood of recurrence in IAs following SACE.

摘要

背景

颅内动脉瘤(IA)在接受支架辅助弹簧圈栓塞术(SACE)后复发是临床实践中的一个重要问题。在本研究中,我们分析了血液中调节性T细胞计数和血浆细胞因子水平,以评估全身炎症程度,并研究它们与接受SACE的IA复发的潜在关联。

方法

一项回顾性研究纳入了189例患有220个未破裂IA的个体,根据Raymond-Roy量表将参与者分为闭塞组和复发组。最初,使用单因素分析来识别临床数据、形态学参数和术前血浆细胞因子水平之间的差异。使用p < 0.05的变量建立逻辑回归模型,并通过使用受试者工作特征(ROC)曲线技术的图形和统计分析来评估所选参数的特异性和敏感性。

结果

与闭塞组相比,复发组中IL-2、IL-10、IL-17和IFN-γ的血浆浓度显著升高。基于二元逻辑回归分析,发现IL-10(比值比 = 1.24,95%置信区间 = 1.06 - 1.46,p = 0.008)、IL-17(比值比 = 1.45,95%置信区间 = 1.17 - 1.82,p < 0.001)和INF-γ(比值比 = 1.28,95%置信区间 = 1.07 - 1.54,p = 0.007)的水平被确定为IA复发的关键独立指标。通过结合IL-2、IL-10、IL-17和INF-γ,实现了最高的预测准确性复发风险,曲线下面积为0.761。

结论

研究结果表明,复发的IA中血浆IL-2、IL-10、IL-17和IFN-γ水平持续升高,这意味着身体的初始炎症水平是SACE后IA复发的主要因素。IL-2、IL-10、IL-17和IFN-γ的组合可能有助于预测SACE后IA复发的可能性。

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