检测颅内动脉瘤破裂出血术后血清缺氧诱导因子1α（HIF-1α）、miR-210表达情况，并探讨其与脑血管痉挛（CVS）的关系。

选取禹城市人民医院神经外科自2015年1月至2018年12月收治的87例颅内动脉瘤破裂急诊自发性蛛网膜下腔出血（SAH）并接受介入栓塞或开颅夹闭治疗的患者为研究对象，采用头颅X线、CT及全脑数字减影血管造影（DSA）检查判断CVS的发生情况，并评估其严重程度。术后3、7 d采用ELISA法检测血清HIF-1α表达情况，采用qRT-PCR法检测血清miR-210表达情况。分析颅内动脉瘤破裂出血患者术后血清HIF-1α、miR-210表达的关系，采用ROC曲线分析颅内动脉瘤破裂出血患者术后3 d血清HIF-1α、miR-210水平对CVS的诊断价值。

87例颅内动脉瘤破裂出血患者出现术后CVS者37例（42.53%），其中轻度CVS 10例（11.49%），中度19例（21.84%），重度8例（90.20%）；术后3、7 d，与无CVS组患者相比，不同程度CVS患者血清中的HIF-1α、miR-210水平均显著升高（P<0.05），且CVS程度越重，血清HIF-1α、miR-210表达水平越高，不同程度CVS患者术后3、7 d时血清HIF-1α、miR-210水平均显著高于术前（P<0.05），术后7 d时血清HIF-1α、miR-210水平均显著低于术后3 d，差异有统计学意义（P<0.05）；颅内动脉瘤破裂出血术后3、7 d患者血清HIF-1α水平与miR-210水平均呈正相关（r=0.381、0.631，P<0.05）；术后3 d血清HIF-1α、miR-210水平及HIF-1α+miR-210联合诊断颅内动脉瘤破裂出血患者CVS的曲线下面积分别为0.834、0.769、0.900，二者联合诊断CVS的敏感度为93.06%，准确度为87.36%，均高于单项指标检测。

颅内动脉瘤破裂出血术后血清HIF-1α、miR-210水平可有效预示CVS的发生，二者可能成为CVS发生、发展的重要生物学指标。

To detect the expressions of hypoxia inducible factor-1α (HIF-1α) and miRNA-210 (miR-210) in serum after intracranial aneurysm rupture hemorrhage, and to explore their relationships with cerebral vasospasm (CVS).

Eighty-seven patients with ruptured intracranial aneurysms who underwent emergency spontaneous subarachnoid hemorrhage (SAH) and interventional embolization or craniotomy from January 2015 to December 2018, were selected as the subjects of study. The occurrence of CVS was assessed by head X-ray, CT and whole brain digital subtraction angiography (DSA), the severity of CVS was assessed, the expression of HIF-1α in serum was detected by ELISA and the expression of miR-210 in serum was detected by qRT-PCR. To analyze the relationship between the expressions of HIF-1α and miR-210 in serum after intracranial aneurysm rupture and hemorrhage, and ROC curve was used to analyze the diagnostic values of serum HIF-1α and miR-210 levels in patients with CVS at 3^rd day after intracranial aneurysm rupture and hemorrhage.

Thirty-seven patients (42.53%) had postoperative CVS after operation in 87 patients with ruptured intracranial aneurysms,including 10 patients with mild CVS (11.49%), 19 patients with moderate CVS (21.84%) and 8 patients with moderate CVS (90.20%). The levels of HIF-1α and miR-210 in serum of CVS patients in varying degrees were significantly higher than those of non-CVS patients at 3^rd day and 7^th day after operation (P<0.05), and the higher the severity of CVS, the higher the expression levels of serum HIF-1α and miR-210. The levels of HIF-1α and miR-210 in serum of CVS patients at 3^rd day and 7^th day after operation were significantly higher than those before operation (P<0.05), and the levels of HIF-1α and miR-210 at 7^th day after operation were significantly lower than those at 3^rd day after operation (P<0.05). Serum HIF-1α level was positively correlated with miR-210 level in patients with ruptured intracranial aneurysms 3^rd and 7^th day after operation (r=0.381, r=0.631, P<0.05). On the 3^rd day after operation, the areas under the curve of levels of serum HIF-1α, miR-210 and HIF-1α+miR-210 diagnosing CVS in patients with ruptured intracranial aneurysm hemorrhage were 0.834, 0.769 and 0.900, respectively, and the sensitivity and accuracy of combined diagnosis of CVS were 93.06% and 87.36%, which were higher than those of single index detections.

Levels of serum HIF-1α and miR-210 after intracranial aneurysm rupture and hemorrhage can effectively predict the occurrence of CVS, and they may be important biological indicators of the occurrence and development of CVS.