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颅内动脉狭窄患者血管内治疗后脑梗死中的内皮糖萼

Endothelial Glycocalyx in Cerebral Infarction After Endovascular Treatment in Patients With Intracranial Artery Stenosis.

作者信息

Zhao Fangfang, Wang Tao, Luo Jichang, Gao Haoyuan, Zheng Yangmin, Wang Rongliang, Fan Junfen, Zhao Haiping, Han Ziping, Luo Yumin, Jiao Liqun

机构信息

Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

CNS Neurosci Ther. 2025 Aug;31(8):e70545. doi: 10.1111/cns.70545.

Abstract

OBJECTIVE

To examine whether plasma glycocalyx levels in patients with severe intracranial arterial stenosis (ICAS) are associated with the prediction of new cerebral infarctions following endovascular treatment.

METHODS

105 patients with ICAS who underwent endovascular treatment were enrolled from September 2020 to June 2021. Plasma glycocalyx components were detected. The condition of the cerebral artery was obtained by high-resolution nuclear magnetic resonance, and risk factors for new cerebral infarction postendovascular treatment in patients with ICAS were analyzed using both univariate and multivariate analyses. The results were presented in a nomogram risk model and evaluated.

RESULTS

The plasma glycocalyx in patients with ICAS exhibited significant differences compared to healthy individuals (p < 0.05). Multivariate analysis revealed eccentricity (OR = 3.599, 95% CI: 1.168-12.478, p = 0.032) and hyaluronic acid (OR = 5.542, 95% CI: 1.545-23.573, p = 0.013) as risk factors (p < 0.05). The risk model encompassing eccentricity, Remodeling index, blood glucose, hyaluronic acid (HA), and age was presented as a Nomogram, with a C-index of 0.810 (95% CI, 0.729-0.890). To further analyze the risk factors affecting HA plasma concentration, the multivariate analysis showed that fibrinogen and hemoglobin A1c (HbA1C) significantly affected changes in HA.

CONCLUSION

We found that HA is a critical factor in predicting adverse events of cerebral infarction after endovascular treatment in patients with ICAS. Additionally, HbA1C and fibrinogen were identified as factors influencing HA changes.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01994161.

摘要

目的

探讨重度颅内动脉狭窄(ICAS)患者的血浆糖萼水平与血管内治疗后新发脑梗死预测之间的相关性。

方法

选取2020年9月至2021年6月期间接受血管内治疗的105例ICAS患者。检测血浆糖萼成分。通过高分辨率核磁共振获取脑动脉情况,并采用单因素和多因素分析对ICAS患者血管内治疗后新发脑梗死的危险因素进行分析。结果以列线图风险模型呈现并进行评估。

结果

ICAS患者的血浆糖萼与健康个体相比存在显著差异(p < 0.05)。多因素分析显示偏心度(OR = 3.599,95%CI:1.168 - 12.478,p = 0.032)和透明质酸(OR = 5.542,95%CI:1.545 - 23.573,p = 0.013)为危险因素(p < 0.05)。包含偏心度、重塑指数、血糖、透明质酸(HA)和年龄的风险模型以列线图形式呈现,C指数为0.810(95%CI,0.729 - 0.890)。为进一步分析影响HA血浆浓度的危险因素,多因素分析表明纤维蛋白原和糖化血红蛋白(HbA1C)显著影响HA的变化。

结论

我们发现HA是预测ICAS患者血管内治疗后脑梗死不良事件的关键因素。此外,HbA1C和纤维蛋白原被确定为影响HA变化的因素。

试验注册

ClinicalTrials.gov标识符:NCT01994161。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33aa/12351062/795f6a081d6a/CNS-31-e70545-g002.jpg

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