脊柱骨折伴急性脊髓损伤患者NLRP3炎症小体及相关因子的变化及临床意义
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作者Author单位AddressE-Mail
杜媛媛 DUYuanyuan 中国人民解放军联勤保障部队第九O一医院 The 901st Hospital Of the Joint Logistics Support Force of PLA 13295696615@163.com 
杨好* YANG Hao 中国人民解放军联勤保障部队第九O一医院 The 901st Hospital Of the Joint Logistics Support Force of PLA 181587333@qq.com 
陈程程 Chen Chengcheng 中国人民解放军联勤保障部队第九O一医院  
何紫艳 He Ziyan 中国人民解放军联勤保障部队第九O一医院  
期刊信息:《中国骨伤》年,第卷,第期,第-页
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中文摘要:目的:研究脊柱骨折伴急性脊髓损伤(SCI)患者NOD样受体蛋白3(NLRP3)炎症小体及相关因子的变化及临床意义。方法:选择2019年6月-2022年3月我院收治的86例脊柱骨折伴急性SCI患者作为SCI组,同期体检的100例健康志愿者作为对照组,收集外周血单个核细胞(PBMC)并检测NLRP3、半胱氨酸蛋白酶-1(Caspase-1)的mRNA表达,收集血清并检测白介素(IL)-1β、IL-18的水平。根据Frankel分级将SCI组分为完全损伤患者和不完全损伤患者,根据日本矫形外科学会(JOA)评分将SCI组分为预后良好组和预后不良组。比较各组间NLRP3、Caspase-1、IL-1β、IL-18的差异,采用logistic回归分析SCI组患者预后不良的影响因素。结果:SCI组患者的PBMC中NLRP3、Caspase-1 mRNA表达水平及血清IL-1β、IL-18水平高于对照组(P<0.05);SCI组中完全损伤患者的PBMC中NLRP3、Caspase-1 mRNA表达水平及血清IL-1β、IL-18水平高于不完全损伤患者P<0.05);SCI组中预后不良患者的PBMC中NLRP3、Caspase-1 mRNA表达水平、血清IL-1β、IL-18水平、完全损伤比例、脊髓水肿或出血比例高于预后良好患者(P<0.05);完全损伤、PBMC中NLRP3 mRNA表达是SCI组预后不良的影响因素(P<0.05)。结论:脊柱骨折合并急性SCI患者NLRP3炎症小体的激活与损伤加重、预后不良有关,NLRP3表达可作为评价预后的标志物。
【关键词】脊柱骨折  急性脊髓损伤  NLRP3炎症小体  白细胞介素  预后
 
Changes and clinical significance of NLRP3 inflammasomes and related factors in patients with spinal fracture complicated with acute spinal cord injury
ABSTRACT  Objective: To investigate the changes and clinical significance of NOD like receptor protein 3 (NLRP3) inflammasomes and related factors in patients with spinal fractures complicated with acute spinal cord injury (SCI). Methods: 86 spinal fracture patients complicated with acute SCI admitted to our hospital from June 2019 to March 2022 were selected as SCI group, and 100 healthy volunteers who underwent physical examination during the same time were selected as control group. Peripheral blood mononuclear cell (PBMC) were collected, and the mRNA expressions of NLRP3 and caspase-1 were detected. Serum was collected and the levels of interleukin (IL)- 1β, IL-18 were detected. According to Frankel's grade, the SCI group was divided into complete injury patients and incomplete injury patients, and according to the Japanese Orthopedic Society (JOA) grade, the SCI group was divided into good prognosis group and poor prognosis group. The difference of NLRP3, Caspase-1, IL-1β, IL-18 among groups were compared, the influencing factors for poor prognosis in SCI patients was analyzed by logistic regression. Result: The mRNA expression levels of NLRP3 and caspase-1 in PBMC and the levels of IL-1β, IL-18 in serum of SCI group were higher than those of the control group (P<0.05). The mRNA expression levels of NLRP3 and caspase-1 in PBMC and the levels of IL-1β, IL-18 in serum of patients with complete injury in the SCI group were higher than those of patients with incomplete injury (P<0.05). The mRNA expression levels of NLRP3 and caspase-1 in PBMC and the levels of IL-1β, IL-18 in serum, the proportion of complete injury, and the proportion of spinal cord edema or bleeding of patients with poor prognosis in the SCI group were higher than those of patients with good prognosis(P<0.05). Complete injury and the mRNA expression of NLRP3 in PBMC were the influencing factors for poor prognosis in the SCI group (P<0.05). Conclusion: The activation of NLRP3 inflammasomes in patients with spinal fractures complicated with acute SCI is associated with worsening injury and poor prognosis, and NLRP3 expression can serve as a marker for evaluating prognosis.
KEY WORDS  Spinal fracture  Acute spinal cord injury  NLRP3 inflammasome  Interleukin  Prognosis
 
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