NLRP3炎症小体与脑梗死后患者神经功能恢复的相关性分析

目的分析脑梗死患者核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体表达与神经功能恢复的关系,为未来脑梗死后患者神经功能的评估与治疗干预提供指导。方法回顾分析2018-01—2019-12河南大学淮河医院收治的102例脑梗死患者资料,应用美国国立卫生院卒中量表(NIHSS)评估患者入院时、入院后第1个月的神经功能缺损程度,NIHSS评分降低≥2分的患者纳入恢复组,其余患者纳入未恢复组;统计患者的一般资料,检测并比较2组NLRP3炎症小体表达。结果入院后第1个月,恢复组(n=70)脑梗死患者的NIHSS评分较入院时降低≥2分,神经功能恢复率68.63%;恢复组患者外周血单核细胞(PBMC)中的NLRP3-mRNA水平低于未恢复患者组(n=32例),差异有统计学意义(P<0.05),其他一般资料组间比较差异无统计学意义(P>0.05)。Logistic回归分析发现,PBMC中NLRP3-mRNA高表达是脑梗死后患者早期神经功能恢复不佳的危险因素(OR>1,P<0.05);NLRP3-mRNA水平与NIHSS评分减分情况(入院时NIHSS评分-入院后第1个月NIHSS评分)呈负相关(r<0,P<0.05)。结论NLRP3炎症小体过表达是脑梗死患者早期神经功能恢复不佳的危险因素,且随着NLRP3炎症小体表达升高,患者早期神经功能恢复情况越差,未来可将抑制NLRP3炎症小体的表达作为脑梗死后患者治疗新靶点,可能对改善患者神经功能恢复现状有积极意义。

Correlation between NLRP3 inflammasome and the recovery of neurological function after cerebral infarction

Objective To analyze the relationship between the expression of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome and the recovery of nerve function in patients with cerebral infarction,to provide guid?ance for the evaluation and therapeutic intervention of patients’neurological function after cerebral infarction in the future.Methods The data of 102 patients with cerebral infarction treated in our hospital from January 2018 to December 2019 were retrospectively ana?lyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of neurological deficits at the time of ad?mission and the first month after admission.Patients with NIHSS score reduced≥2 points were included in the recovery group,and the rest were included in the non-recovery group;counted the general information of patients,and detected and compared the expres?sion of NLRP3 inflammasome between the two groups.Results In the first month after admission,the NIHSS score of patients with cerebral infarction in the recovery group(70 cases)was lower than that at admission with decrease of≥2 points,and the recovery rate of neurological function was 68.63%;the level of NLRP3-mRNA in peripheral blood mononuclear cells(PBMC)of the recovery group was lower than that of the non-recovery group(32 cases),and there was statistically significant difference(P<0.05).Com?pared between other general data groups,there was no statistically significant difference(P>0.05).Logistic regression analysis found that high expression of NLRP3-mRNA in PBMC was a risk factor for poor neurological recovery in patients with early cerebral infarc?tion(OR>1,P<0.05);the level of NLRP3-mRNA was negatively correlated with the reduction of NIHSS score(NIHSS score at ad?mission-NIHSS score at the first month after admission)(r<0,P<0.05).Conclusion Overexpression of NLRP3 inflammasome is a risk factor for poor neurological recovery in patients with cerebral infarction.And as the expression of NLRP3 inflammasome increas?es,the patient’s early neurological function recovery becomes worse.In the future,the inhibition of the expression of NLRP3 inflam?masomes can be used as a new target for the treatment of patients after cerebral infarction,which may be of positive significance for improving the recovery of patients’neurological function.