The relationship between serum LTB4,YKL-40,MMP-3 and postoperative cerebrovascular spasm in patients under-going interventional embolization for intracranial aneurysms

Sun Han; Fu Qiang; Zhao Lingtong; He Shuren; Cheng Youhua; Zhu Xiaofei; Liu Jianxiong

doi:10.3969/j.issn.1671-6450.2025.12.011

Abstract：Objective To discuss the relationship between serum leukotriene B4(LTB4),human cartilage glycoprotein(YKL-40),matrix metalloproteinase-3(MMP-3)and postoperative cerebrovascular spasm(CVS)in patients with intracranial aneurysms(IAs)undergoing interventional embolization.Methods A total of 122 patients diagnosed with IAs were admitted to the Department of Neurology of the 920th Hospital of the Joint Logistics Support Force of the Chinese Peo-ple's Liberation Army from January 2023 to March 2025 and were included in the IAs group.Based on whether CVS oc-curred,they were divided into CVS subgroups and non-CVS subgroups.A total of 100 healthy individuals who underwent physical examinations at the hospital during the same period were included in the healthy control group.ELISA assay for ser-um LTB4,YKL-40,and MMP-3 levels.Compare serum LTB4,YKL-40,and MMP-3 levels between subjects;Record the inci-dence of CVS in IA patients after surgery;Multifactorial logistic regression analysis of factors influencing the occurrence of CVS after surgery in patients with IAs;ROC curve analysis of the predictive value of serum LTB4,YKL-40,and MMP-3 lev-els for the occurrence of CVS after surgery in patients with IAs;Relative risk analysis of the effects of different LTB4,YKL-40,and MMP-3 levels on the occurrence of postoperative CVS in IAs patients.Results The serum levels of LTB4,YKL-40,and MMP-3 in the IAs group were higher than those in the healthy control group(t/P=27.101,32.638,12.340,respec-tively;all P＜0.001).The serum levels of LTB4,YKL-40,and MMP-3 were significantly higher in the CVS subgroup than in the non-CVS subgroup(t/P=5.078,5.847,5.030,respectively;all P＜0.001).The incidence of CVS in IAs patients after surgery was 32.79％.Elevated serum levels of LTB4,YKL-40,and MMP-3 are all risk factors for the occurrence of CVS after surgery in IAs patients[OR(95％CI)=6.781(3.388-13.571),7.332(3.315-16.217),7.662(3.754-15.638)].The AUC values for predicting the occurrence of CVS in IAs patients postoperatively were 0.732,0.786,0.816,and 0.904 for serum LTB4,YKL-40,MMP-3 levels,and the combination of the three,respectively.The combined prediction was superior to the individual predictions(Z=3.492,2.903,2.312;P=0.001,0.004,0.021).Patients with high levels of serum LTB4,YKL-40,and MMP-3 had a risk of CVS that was 4.272 times,3.141 times,and 2.478 times higher than patients with low levels,respectively.Conclusion Serum LTB4,YKL-40,and MMP-3 are elevated in patients with CVS after IAs surgery.The combination of serum LTB4,YKL-40,and MMP-3 has high value in predicting postoperative CVS in patients with IAs.