Abstract: ObjectiveTo observe the expressions of mitogen-activated protein kinase p38(P38MAPK) and caspase-3 in the aneurysm wall of patients with intracranial aneurysm(ICA), and to analyze their relationship with ICA. 
MethodsThirty patients(30 artery aneurysm wall tissues) with intracranial aneurysm who underwent craniotomy in our hospital were selected as the observation group. In addition, 20 patients(20 normal arterial vascular wall tissues) with cranial trauma(confirmed by CT and MRI as non-vascular diseases) who underwent craniotomy in our hospital during the same period were selected as the control group. The patients in the observation group were followed up for 12 months, and GOS score was used to evaluate the prognosis: 1-3 points were poor prognosis and 4-5 points were good prognosis. The expression of P38MAPK and caspase-3 in artery aneurysm wall tissues and normal arterial vascular wall was measured by immunohistochemistry, and the relationships between their expression and the clinicopathological characteristics of patients with ICA were analyzed. Spearman was used to analyze the correlation between the expression of P38MAPK and caspase-3 in ICA wall tissue in the observation group, and COX regression was used to analyze the factors affecting the prognosis of patients with intracranial aneurysm. 
ResultsThe positive expression rate of P38MAPK in the observation group(60.00%) was significantly higher than that(10.00%) in the control group, and the positive expression rate of caspase-3(33.33%) was significantly lower than that in the control group(80.00%)(P＜0.05). The expressions of P38MAPK and caspase-3 in ICA wall tissue were related to the Hunt-hess grade(P＜0.05). Spearman analysis showed that there was a significant negative correlation between the expression of P38MAPK and caspase-3 in ICA wall tissue of the observation group(r=-0.513, P＜0.05). Multivariate COX regression analysis showed that Hunt-hess grade, high P38MAPK expression and low caspase-3 expression were independent risk factors for the prognosis of patients with ICA(P＜0.05). 
ConclusionThe expression of P38MAPK is significantly higher and the expression of caspase-3 is significantly lower in the ICA wall. Both of them are significantly and negatively correlated with each other, and related to the Hunt-hess grade in patients. Combined detection of the two indicators may have certain reference value for the condition monitoring and prognosis evaluation of ICA.

Key words: intracranial aneurysm, p38 mitogen-activated protein kinases, cysteine proteases