Predictive value of serum soluble intercellular adhesion molecule 1 and cysteine aspartate proteolytic enzyme 3 levels in cerebral vasospasm after intracranial ruptured aneurysm surgery
YIN Hang FENG Lijun XIAO Longhai LI Changge QIN Hao
Department of Neurosurgery, Zaozhuang Municipal Hospital, Shandong Province, Zaozhuang 277100, China
Abstract：Objective To investigate the predictive value of serum soluble intercellular adhesion molecule 1 (SICAM-1) and cysteine aspartate proteolytic enzyme 3 (caspase-3) levels in cerebral vasospasm (CVS) after intracranial ruptured aneurysm surgery. Methods A total of 203 patients with ruptured intracranial aneurysm subarachnoid hemorrhage (SAH) admitted to Zaozhuang Municipal Hospital, Shandong Province from January 2016 to December 2019 were selected. All of them received craniotomy clipping or interventional embolization treatment, and underwent digital subtraction angiography four days after surgery. According to different degrees of postoperative CVS, they were divided into severe CVS group (19 cases), moderate CVS group (44 cases), mild CVS group (23 cases) and no CVS group (117 cases). Serum levels of caspase-3 and SICAM-1 were detected before and 3, 7 days after surgery. The serum levels of SICAM-1 and caspase-3 in the four groups were compared before and after intracranial ruptured aneurysm. The correlation between serum SICAM-1 and caspase-3 after intracranial ruptured aneurysm was analyzed by Pearson correlation coefficient. Receiver operating characteristic (ROC) curve was drawn to determine the predictive value of serum SICAM-1 and caspase-3 on postoperative CVS of ruptured intracranial aneurysm three days after surgery. Results Serum levels of SICAM-1 and caspase-3 in the four groups 3 and 7 days after surgery were higher than those before surgery, and serum levels of SICAM-1 and caspase-3 seven days after surgery were lower than those three days after surgery (P < 0.05). Pearson correlation andlysisshowed that there was a positive correlation between serum SICAM-1 and caspase-3 levels of ruptured intracranial aneurysm 3 and 7 days after surgery (r = 0.493, 0.585, P < 0.05). The ROC curve showed that the area under the curve, sensitivity and specificity of SICAM-1 + caspase-3 in the diagnosis of postoperative CVS of ruptured intracranial aneurysm 3 days after surgery were higher than those of SICAM-1 and caspase-3 alone. Conclusion Serum levels of SICAM-1 and caspase-3 in patients with intracranial ruptured aneurysm after surgery are significantly increased, and combined detection can effectively predict the occurrence of CVS.
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