Changes in serum occludin and SDC-1 levels before and after interventional embolization in elderly patients with aneurysms and their relationship with disease outcomes

QIU Zhenfang; JIN Xiaoqing; XIE Jiayong; WANG Qian; LI Xiang

doi:10.3969/j.issn.1671-2897.2026.02.014

Abstract：Objective To investigate the changes in serum occludin and syndecan-1(SDC-1)levels before and after interventional embolization in elderly patients with aneurysms and their association with disease outcomes.Methods A retrospective study was conducted on 162 elderly patients with intracranial aneurysms admitted to Xinghua People's Hospital Affiliated to Yangzhou University from February 2019 to January 2025,all of whom underwent interventional embolization.Serum occludin and SDC-1 levels were measured by ELISA on the day before surgery and 7 days after surgery.Patients were followed up for 3 months after surgery and classified into a good outcome group(modified Rankin scale(mRS)≤2,n=134)and a poor outcome group(mRS>2,n=28)based on the mRS scores.Serum marker levels were analyzed in these two groups,and independent risk factors for disease outcomes were screened by multivariate logistic regression analysis.The predictive value was analyzed using the ROC curve.Results On the day before surgery,the serum occludin and SDC-1 levels between the poor outcome group and the good outcome group was not significantly different(P>0.05).Seven days after surgery,serum occludin and SDC-1 levels in both groups were lower,but the levels in the poor outcome group were higher compared with good outcome group(P<0.05).The proportions of hypertension,Fisher grade 3-4,Hunt-Hess grade Ⅲ-Ⅳ,and cerebral vasospasm in the poor outcome group were higher than those in the good outcome group,while the Glasgow coma scale score was lower than that in the good outcome group(P<0.05).Multivariate analysis showed that hypertension,Hunt-Hess grade Ⅲ-Ⅳ,cerebral vasospasm,and high serum occludin and SDC-1 levels 7 days after surgery were independent risk factors for poor outcomes in elderly patients with aneurysms after interventional embolization(P<0.05).ROC analysis showed that the area under the curve(AUC)of the combined(serial)prediction of serum occludin and SDC-1 7 days after surgery for disease outcome in elderly patients with aneurysms after interventional embolization was 0.905,which was higher than that of serum occludin or SDC-1(0.783 and 0.851 respectively;Z=10.409,11.761,P<0.001).Conclusions Serum occludin and SDC-1 levels decrease after interventional embolization in elderly patients with aneurysms.High serum occludin and SDC-1 levels 7 days after surgery are closely related to poor disease outcome.The combination of serum occludin and SDC-1 7 days after surgery has good predictive value for disease outcome in elderly patients with aneurysms after interventional embolization and can be used as a reference indicator for evaluating disease outcome.