| 脊柱骨折伴急性脊髓损伤NOD样受体蛋白3炎症小体及相关因子变化及其与预后的相关性 |
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投稿时间：2024-03-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 杜媛媛 |
DU Yuan-yuan |
中国人民解放军联勤保障部队第九〇一医院康复医学科, 安徽 合肥 230000 |
Department of Rehabilitation Medicine, the 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230000, Anhui, China |
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| 杨好 |
YANG Hao |
中国人民解放军联勤保障部队第九〇一医院康复医学科, 安徽 合肥 230000 |
Department of Rehabilitation Medicine, the 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230000, Anhui, China |
181587333@qq.com |
| 陈程程 |
CHEN Cheng-cheng |
中国人民解放军联勤保障部队第九〇一医院康复医学科, 安徽 合肥 230000 |
Department of Rehabilitation Medicine, the 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230000, Anhui, China |
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| 何紫艳 |
HE Zi-yan |
中国人民解放军联勤保障部队第九〇一医院康复医学科, 安徽 合肥 230000 |
Department of Rehabilitation Medicine, the 901st Hospital of the Joint Logistics Support Force of PLA, Hefei 230000, Anhui, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第7期，第684-688页 |
| DOI：10.12200/j.issn.1003-0034.20230836 |
| 基金项目: |
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中文摘要:
目的：研究脊柱骨折伴急性脊髓损伤(spinal cord injury,SCI)患者 NOD 样受体蛋白 3(NOD like receptorprotein 3,NLRP3)炎症小体及相关因子与预后的相关性。
方法：选择 2019 年 6 月至 2022 年 3 月收治的 86 例脊柱骨折伴急性 SCI 患者作为 SCI 组,其中男 48 例,女 38 例,年龄 33~56(43.48±6.58)岁;同期体检的 100 例健康志愿者作为对照组,男 56 例,女 44 例,年龄 34~53(45.13±6.43)岁。收集外周血单个核细胞 (peripheral blood mononuclear cell,PBMC)并检测 NLRP3、半胱氨酸蛋白酶-1(cysteinyl aspartate specific proteinase-1,Caspase-1)的 mRNA 表达,收集血清并检测白细胞介素-1β(interleukin,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(Japanese Orthopaedic Association,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 组及对照组的 PBMC 中 NLRP3 mRNA[(1.41±0.33) vs (1.00±0.19)]、Caspase-1 mRNA[(1.44±0.35) vs (1.00±0.16)]表达水平及血清中 IL-1β[(45.34±13.22) pg·ml-1 vs (16.58±4.24) pg·ml-1]、IL-18 含量[(40.95±8.77) pg·ml-1 vs(12.57±3.68) pg·ml-1],SCI 组均高于对照组(P<0.05)。SCI 组中完全损伤患者的 PBMC 中 NLRP3 mRNA(1.63±0.34)、Caspase-1 mRNA(1.67±0.27)表达水平及血清 IL-1β(51.09±11.10) pg·ml-1、IL-18(47.65±7.93) pg·ml-1 高于不完全损伤患者[(1.31±0.27)、(1.34±0.33)、(42.85±13.36)、(38.05±7.48) pg·ml-1](P<0.05);SCI 组中预后不良患者的 NLRP3mRNA(1.66±0.31)、Caspase-1 mRNA(1.72±0.31)、血清 IL-1β(51.21±11.31) pg·ml-1、IL-18(45.70±7.25) pg·ml-1、完全损伤(21 例)、脊髓水肿或出血 (15 例)高于预后良好患者[(1.28±0.26)、(1.37±0.36)、(42.79±13.25) pg·ml-1、(38.90±8.63) pg·ml-1、5 例、20 例],(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 |
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| Changes and clinical significance of NLRP3 inflammasomes and related factors in patients with spinal fracture complicated with acute spinal cord injury |
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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 Eighty-six spinal fracture patients complicated with acute SCI admitted to hospital from June 2019 to March 2022 were selected as SCI group,There were 48 males and 38 females,with an average age of (43.48±6.58) years old. And 100 healthy volunteers who underwent physical examination during the same time were selected as control group,including 56 males patients and 44 females patients,with an average age of (45.13±6.43) years old. 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.
Results The mRNA expression levels of NLRP3 (1.41±0.33) and Caspase-1 (1.44±0.35) in PBMC and the levels of IL-1β(45.34±13.22) pg·ml-1,IL-18(40.95±8.77) pg·ml-1 in serum of SCI group were higher than those of the control group[(1.00±0.19),(1.00±0.16),(16.58±4.24) pg· ml-1,(12.57±3.68) pg·ml-1] (P<0.05). The mRNA expression levels of NLRP3(1.63±0.34) and Caspase-1 (1.67±0.27) in PBMC and the levels of IL-1β(51.09±11.10) pg·ml-1,IL-18 (47.65±7.93) pg·ml-1 in serum of patients with complete injury in the SCI group were higher than those of patients with incomplete injury[(1.31±0.27),(1.34±0.33),(42.85±13.36) pg·ml-1, (38.05±7.48) pg·ml-1] (P<0.05). The mRNA expression levels of NLRP3 (1.66±0.31) and Caspase-1 (1.72±0.31)in PBMC and the levels of IL-1β (51.21±11.31) pg·ml-1,IL-18 (45.70±7.25) pg·ml-1 in serum,the proportion of complete injury(21 patients),and the proportion of spinal cord edema or bleeding of patients(15 patients) with poor prognosis in the SCI group were higher than those of patients with good prognosis[(1.28±0.26),(1.37±0.36),(42.79±13.25) pg·ml-1、(38.90± 8.63) pg·ml-1,5、20 cases](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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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杜媛媛,杨好,陈程程,何紫艳.脊柱骨折伴急性脊髓损伤NOD样受体蛋白3炎症小体及相关因子变化及其与预后的相关性[J].中国骨伤,2024,37(7):684~688 |
| 英文格式: | DU Yuan-yuan,YANG Hao,CHEN Cheng-cheng,HE Zi-yan.Changes and clinical significance of NLRP3 inflammasomes and related factors in patients with spinal fracture complicated with acute spinal cord injury[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(7):684~688 |
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