血管内介入栓塞治疗老年颅内前循环破裂动脉瘤疗效及血清中MMP-9和Caspase-3水平变化

目的 探究血管内介入栓塞治疗老年颅内前循环破裂动脉瘤疗效及血清中MMP-9、Caspase-3水平变化.方法 选取本院接收的老年颅内前循环破裂动脉瘤患者81例,根据治疗方法不同分为开颅手术组和血管内介入栓塞组,另取老年健康人群20例作为健康对照组.比较开颅手术组和血管内介入栓塞组治疗前后的格拉斯哥意识障碍评分系统(Glasgow Coma Scale,GCS)、格拉斯哥预后评分系统(Glasgow Outcome Scale,GOS)、住院时间和并发症发生率,比较健康对照组以及开颅手术组和血管内介入栓塞组治疗前后血清中含半胱氨酸的天冬氨酸蛋白水解酶3(Cysteine-containing aspartate-specific proteases 3,Caspase-3)和质金属蛋白酶-9(Matrix Metalloproteinase-9,MMP-9)水平.结果 血管内介入栓塞组和开颅手术组术后的GCS评分、GOS评分、Caspase-3、MMP-9均显著大于术前,且血管内介入栓塞组术后均显著高于开颅手术组术后(均P＜ 0.05);血管内介入栓塞组住院时间和并发症发生率均显著低于开颅手术组(均P＜ 0.05).结论 血管内介入栓塞组治疗老年颅内前循环破裂动脉瘤具有更佳的有效性和安全性.

Endovascular embolization for elderly patients with ruptured intracranial anterior circulation aneurysms and changes of serum levels of MMP-9 and Caspase-3

Objective To explore the effect of endovascular embolization for elderly patients with ruptured intracranial anterior circulation aneurysms and the changes of the serum levels of MMP-9 and Caspase-3.Methods 81 elderly patients with ruptured intracranial anterior circulation aneurysms were divided into a craniotomy group and an endovascular embolization group according different treatment methods.20 healthy elderly persons were selected as a control group.The Glasgow Coma Scale(GCS),Glasgow Outcome Scale(GOS),hospital stay,and incidence of complications before and after treatment were compared between these two groups.The serum levels of Cysteine-containing aspartate-specific proteases 3(Caspase-3) and Matrix Metalloproteinase-9 (MMP-9) before and after treatment were compared between these two groups.Results The scores of GCS and GOS and the serum levels of Caspase-3 and MMP-9 were significantly higher than before treatment in both groups and were in the craniotomy group than in the endovascular embolization group after treatment (P ＜ 0.05).The hospital stay was shorter and the incidence of complications was significantly lower in endovascular embolization group than in the craniotomy group (P ＜ 0.05).Conclusions Endovascular embolization in the treatment of ruptured intracranial anterior circulation aneurysms has better efficacy and safety than craniotomy.