关键词: 血管生成素样蛋白8, 血管细胞黏附分子-1, 颅内动脉瘤, 脑血管痉挛, 预测价值

Abstract: Objective The combined detection of serum angiopoietin-like protein 8 (ANGPTL8) and Vascular cell adhesion molecule-1 (VCAM-1) levels was analyzed for the predictive value of cerebral vasospasm (CVS) after intracranial aneurysm embolization. Methods A total of 196 patients who underwent intracranial aneurysm embolization in our hospital from March 2019 March 2022 were selected as the study subjects,99 patients with CVS were in the CVS group,and 97 patients without CVS were in the non CVS group.Serum ANGPTL8 and VCAM-1 levels were detected by ELISA;the correlation between serum ANGPTL8 and VCAM-1 levels was analyzed by Pearson method,Logistic regression was used to analyze the influencing factors of CVS in patients undergoing intracranial aneurysm embolization;ROC curve was used to analyze the serum levels of ANGPTL8 and VCAM-1 to predict the cutoff value of CVS in patients undergoing intracranial aneurysm embolization;four grid table method was used to analyze the predictive value of ANGPTL8,VCAM-1 and their combination on the occurrence of CVS in patients undergoing intracranial aneurysm embolization. Results The differences between CVS and non-CVS groups were statistically significant in hypertension, Hunt-Hess grade, and Glasgow coma (GCS) scores (P<0.05). The serum ANGPTL8 and VCAM-1 levels in the CVS group were significantly higher than those in the non-CVS group (P<0.05).There was a positive correlation between serum ANGPTL8 and VCAM-1 (r=0.468,P<0.05).Multivariate analysis showed that high level of ANGPTL8 (OR=3.652,95% CI:1.434-9.302),high level of VCAM-1 (OR=2.619,95% CI:1.212-5.658),Hunt Hess grade Ⅲ-Ⅳ (OR=1.927,95% CI:1.104-3.362),GCS score of 3-8(OR=2.813,95% CI:1.257-6.295) were independent risk factors for CVS in patients undergoing intracranial aneurysm embolization.The AUC of serum ANGPTL8 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.844,and the cut-off value was 189.233U/L;the AUC of serum VCAM-1 level in predicting CVS in patients undergoing intracranial aneurysm embolization was 0.795,and the cutoff value was 17.984mg/L.The accuracy,sensitivity and specificity of the combined prediction for CVS were 89.81%,93.94% and 85.57%,respectively,which were obviously higher than those of the single prediction.Conclusion The serum levels of ANGPTL8 and VCAM-1 in CVS group are obviously higher than those in non CVS group.The combination of the two has a high predictive value for CVS after intracranial aneurysm embolization.

Key words: angiopoietin like protein 8, vascular cell adhesion molecule-1, intracranial aneurysm, cerebral vasospasm, predictive value