重症肺炎患者NLRP3信号通路及相关细胞因子表达及其诊断价值

Expressions of NLRP3 signaling pathways and related cytokines in severe pneumonia patients and their diagnostic values

目的探究重症肺炎患者NOD样受体热蛋白结构域相关蛋白3(NLRP3)信号通路及相关细胞因子的表达及其诊断价值。方法选取焦作市第二人民医院2020年1月-2023年1月收治的216例肺炎患者为研究组,根据其病情严重程度,分为重症组113例和轻症组103例,另选取216名同期体检健康者为对照组;分别检测各组外周血NLRP3、半胱氨酸蛋白酶-1(Caspase-1)、白细胞介素(IL)-1β、IL-18、血清淀粉样蛋白A(SAA)、单核细胞趋化蛋白-1(MCP-1)水平;采用Spearman相关分析各项指标与病情严重程度的相关性,受试者工作特征(ROC)曲线分析各指标对重症肺炎的诊断价值。结果研究组NLRP3、Caspase-1、IL-1β、IL-18、SAA、MCP-1水平高于对照组(P<0.05);重症组NLRP3、Caspase-1、IL-1β、IL-18、MCP-1水平高于轻症组(P<0.05),且表达水平与病情严重程度呈正相关(P<0.05);各指标联合诊断重症肺炎的曲线下面积(AUC)值为0.933,敏感度为90.27%,特异度为82.52%。结论重症肺炎患者NLRP3、Caspase-1、IL-1β、IL-18、MCP-1水平呈高表达,且表达与病情严重程度呈正相关,联合检测可提高重症肺炎患者的诊断价值。

OBJECTIVE To explore the expressions of NOD-like receptor heat protein domain associated protein 3(NLRP3)signaling pathways and related inflammatory cytokines in the patients with severe pneumonia and analyze the diagnostic values.METHODS A total of 216 patients with pneumonia who were treated in the Second People′s Hospital of Jiaozuo City from Jan 2020 to Jan 2023 were assigned as the study group and were divided into the severe group with 113 cases and the mild group with 103 cases according to the severity of disease.Meanwhile,216 healthy people who received physical examination were chosen as the control group.The levels of peripheral blood NLRP3,cysteine proteinase-1(Caspase-1),interleukin(IL)-1β,IL-18,serum amyloid protein A(SAA)and monocyte chemoattractant protein(MCP)were detected for the patients.Spearman correlation analysis was performed for the association between the indexes and the severity of illness condition,and the values of the indexes in diagnosis of severe pneumonia were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The levels of NLRP3,Caspase-1,IL-1β,IL-18,SAA and MCP-1 of the study group were significantly higher than those of the control group(P<0.05);the levels of NLRP3,Caspase-1,IL-1β,IL-18 and MCP-1 of the severe group were significantly higher than those of the mild group(P<0.05),and the expression levels of the indexes were positively correlated with the severity of illness condition(P<0.05).The area under curve(AUC)of the joint detection of the indexes was 0.933 in diagnosis of the severe pneumonia,with the sensitivity 90.27%,the specificity 82.52%.CONCLUSION The patients with severe pneumonia show high expression levels of NLRP3,Caspase-1,IL-1β,IL-18 and MCP-1,which are positively correlated with the severity of illness condition.The joint detection of the indexes may raise the diagnostic value of the severe pneumonia patients.