急性脑梗死患者外周血炎性小体NLRP3表达及与颅内动脉血栓病理成分、预后的相关性分析

Analysis of Expression of NLRP3 Inflammatory Bodies in Peripheral Blood of Patients with Acute Cerebral Infarction and Its Correlation with Pathological Components and Prognosis of Intracranial Arterial Thrombosis

目的 探讨急性脑梗死(ACI)患者外周血炎性小体NOD样受体热蛋白结构域相关蛋白3(NLRP3)表达,并分析其与颅内动脉血栓病理成分、预后的相关性。方法 选取2022年1—12月收治的92例ACI作为观察组,另选取健康志愿者92例作为对照组,检测外周血NLRP3 mRNA、蛋白及血清水平。观察组行机械取栓治疗,采用HE染色法半定量分析血栓取出物,并分为红细胞富集血栓者、纤维蛋白富集血栓者。比较不同组别、不同血栓病理成分、不同预后患者外周血炎性小体NLRP3水平,分析其与血栓病理成分相关性及对预后不良风险的关系。结果 观察组NLRP3 mRNA、蛋白表达及血清水平高于对照组,红细胞富集血栓者高于纤维蛋白富集血栓者,且与红细胞富集血栓呈正相关(P<0.05,P<0.01);预后不良者NLRP3 mRNA、蛋白表达及血清水平高于预后良好者(P<0.01);NLRP3 mRNA、蛋白高表达及血清高水平患者预后不良风险分别是低表达、低水平患者的2.182、2.500、2.182倍(P<0.05)。结论 ACI患者外周血炎性小体NLRP3水平升高,且与颅内动脉红细胞富集血栓相关,可增加预后不良发生风险。

Objective To investigate the expression of NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammatory bodies in peripheral blood of patients with acute cerebral infarction(ACI),and to analyze its correlation with pathological components and prognosis of intracranial arterial thrombosis.Methods In total,92 patients with ACI treated from January to December 2022 were selected as observation group,and 92 healthy volunteers were selected as control group.Peripheral blood NLRP3 mRNA,protein,and serum levels were detected.Observation group was treated with mechanical thrombectomy,semi-quantitative analysis of thrombus extract by HE staining method,and divided into patients with erythrocyte-rich thrombi and patients with fibrin-rich thrombi.The level of NLRP3 inflammatory bodies in peripheral blood of patients with different groups,different pathological components of thrombus and different prognosis were compared,and the correlation between NLRP3 and pathological components of thrombus and its relationship with the risk of poor prognosis were analyzed.Results The mRNA,protein expression and serum levels of NLRP3 in the observation group were higher than those in the control group(P<0.01),and the concentration of thrombus in patients with erythrocyte-rich thrombi was higher than that in patients with fibrin-rich thrombi,and there was a positive correlation with erythrocyte-rich thrombi(P<0.05,P<0.01).The mRNA,protein expression and serum levels of NLRP3 in patients with poor prognosis were higher than those in patients with good prognosis(P<0.01).The risk of poor prognosis in patients with high expression of NLRP3 mRNA and protein and high serum level was 2.182 times,2.500 times,and 2.182 times,respectively,compared with low expression and low level of NLRP3(P<0.05).Conclusion The level of NLRP3 inflammatory bodies in peripheral blood of ACI patients is increased,which is related to the accumulation of intracranial arterial erythrocyte-rich thrombi,and may increase the risk of poor prognosis.