[1]孙倩,刘晨,孙前雪.创伤性脊髓损伤患者血清核苷酸结合寡聚化结构域样受体蛋白3、半乳糖蛋白3水平与预后的相关性[J].中国中医骨伤科杂志,2024,32(05):25-30.[doi:10.20085/j.cnki.issn1005-0205.240505]
　SUN Qian,LIU Chen,SUN Qianxue.The Correlation between Serum Nucleotide Binding Oligomeric Domain Like Receptor Protein 3 and Galactoprotein 3 Levels and Prognosis in Patients with Traumatic Spinal Cord Injury[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(05):25-30.[doi:10.20085/j.cnki.issn1005-0205.240505]
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创伤性脊髓损伤患者血清核苷酸结合寡聚化结构域样受体蛋白3、半乳糖蛋白3水平与预后的相关性()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年05期
页码:
25-30
栏目:
临床研究
出版日期:
2024-05-05

文章信息/Info

Title:
The Correlation between Serum Nucleotide Binding Oligomeric Domain Like Receptor Protein 3 and Galactoprotein 3 Levels and Prognosis in Patients with Traumatic Spinal Cord Injury
文章编号:
1005-0205(2024)05-0025-06
作者:
孙倩1; 刘晨1; 孙前雪1
1保定市第一医院(河北 保定,071000)
Author(s):
SUN Qian1; LIU Chen1; SUN Qianxue1
1Baoding First Hospital,Baoding 071000,Hebei China.
关键词:
创伤性脊髓损伤;  脊髓损伤程度;  预后;  核苷酸结合寡聚化结构域样受体蛋白3;  半乳糖蛋白3
Keywords:
traumatic spinal cord injury;  degree of spinal cord injury;  prognosis;  nod-like receptor pyrin domain-containing 3;  galectin-3
分类号:
R683.2
DOI:
10.20085/j.cnki.issn1005-0205.240505
文献标志码:
A
摘要:
目的:探讨血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、半乳糖蛋白3(Gal-3)水平与创伤性脊髓损伤(TSCI)患者脊髓损伤程度和预后的关系。方法:前瞻性研究2019年3月至2023年3月收治的创伤性脊髓损伤患者195例(TSCI组),美国脊髓损伤协会(ASIA)A/B级77例(A/B级组),C/D级118例(C/D级组); 预后不良80例(预后不良组),预后良好115例(预后良好组)。另选择195例单纯脊柱骨折患者(脊柱骨折组)和92例健康志愿者(对照组)。检测血清NLRP3、Gal-3水平,多因素Logistic回归分析影响创伤性脊髓损伤患者术后预后不良的因素,受试者操作特征曲线(ROC)分析NLRP3与Gal-3预测创伤性脊髓损伤患者术后预后不良的价值。结果:TSCI组血清NLRP3(TSCI组(69.24±16.08)pg/mL vs 脊柱骨折组(35.05±10.71)pg/mL,对照组(10.02±2.43)pg/mL)、Gal-3(TSCI组(11.96±2.48)μg/L vs 脊柱骨折组(5.95±1.36)μg/L,对照组(3.02±0.53)μg/L)水平高于脊柱骨折组和对照组(P<0.05)。A/B级组血清NLRP3、Gal-3水平高于C/D级组,差异有统计学意义(P<0.05),预后不良组血清NLRP3和Gal-3水平高于预后良好组,差异有统计学意义(P<0.05)。ASIA神经和功能分级A/B级、椎管侵占率≥50%、高NLRP3和高Gal-3是创伤性脊髓损伤患者术后预后不良的危险因素(P<0.05)。NLRP3和Gal-3预测创伤性脊髓损伤患者术后预后不良的曲线下面积为0.795(95%CI=0.732～0.849)和0.798(95%CI=0.735～0.852),联合NLRP3和Gal-3预测创伤性脊髓损伤患者术后预后不良的曲线下面积为0.893(95%CI=0.841～0.933),大于单独指标预测(P<0.05)。结论:创伤性脊髓损伤患者血清Gal-3和NLRP3水平显著增高,且与脊髓损伤程度加重以及术后预后不良的发生有关,Gal-3和NLRP3可作为创伤性脊髓损伤预后的标志物。
Abstract:
Objective:To investigate the relationship between serum levels of nucleotide binding oligomeric domain-like receptor protein 3(NLRP3)and galactoprotein 3(Gal-3)and spinal cord injury degree and prognosis in patients with traumatic spinal cord injury(TSCI).Methods:195 TSCI patients(TSCI group)from March 2019 to March 2023 were prospectively analyzed,including 77 cases of American Spinal Cord Injury Association(ASIA)grade A/B(A/B group),118 cases of C/D(C/D group),80 cases of poor prognosis(poor prognosis group)and 115 cases of good prognosis(good prognosis group).In addition,195 patients with simple spinal fracture(spinal fracture group)and 92 healthy volunteers(control group)were selected.Serum NLRP3 and Gal-3 levels were detected,the correlation between NLRP3 and Gal-3 was analyzed by Pearson,and the factors affecting postoperative poor prognosis of TSCI patients were analyzed by multivariate logistic regression.Receiver operating characteristic curve(ROC)analysis of NLRP3 and Gal-3 in predicting postoperative poor prognosis in patients with TSCI.Results:The levels of NLRP3((69.24±16.08)pg/mL,(35.05±10.71)pg/mL,(10.02±2.43)pg/mL)and Gal-3((11.96±2.48)μg/L,(5.95±1.36)μg/L,(3.02±0.53)μg/L)in TSCI group were higher than those in spinal fracture group and control group(P<0.05).The serum NLRP3 and Gal-3 levels in grade A/B groups were higher than those in grade C/D groups(P<0.05),and the serum NLRP3 and Gal-3 levels in poor prognosis group were higher than those in good prognosis group(P<0.05).ASIA nerve and function grade A/B,spinal canal invasion rate ≥50%,high NLRP3 and high Gal-3 were risk factors for poor prognosis in TSCI patients after surgery(P<0.05).The area under the curve of NLRP3 and Gal-3 in predicting postoperative poor prognosis of TSCI patients was 0.795(95%CI=0.732-0.849)and 0.798(95%CI=0.735-0.852),and the area under the curve of combined NLRP3 and Gal-3 in predicting postoperative poor prognosis of TSCI patients was 0.893(95%CI=0.841-0.933),which was greater than that predicted by single index(P<0.05).Conclusion:Serum Gal-3 and NLRP3 levels in TSCI patients are significantly increased,which is associated with the severity of spinal cord injury and poor prognosis after surgery.Gal-3 and NLRP3 can be used as prognostic markers of TSCI.

参考文献/References:

[1] ROUANET C,REGES D,ROCHA E,et al.Traumatic spinal cord injury:current concepts and treatment update[J].Arq Neuropsiquiatr,2017,75(6):387-393.
[2] WANG H D,WEI Z J,LI J J,et al.Application value of biofluid-based biomarkers for the diagnosis and treatment of spinal cord injury[J].Neural Regen Res,2022,17(5):963-971.
[3] CHEN Y,WU L,SHI M,et al.Electroacupuncture inhibits NLRP3 activation by regulating CMPK2 after spinal cord injury[J].Front Immunol,2022,13:788556.
[4] PUIGDELLÍVOL M,ALLENDORF D H,BROWN G C.Sialylation and galectin-3 in microglia-mediated neuroinflammation and neurodegeneration[J].Front Cell Neurosci,2020,14:162.
[5] 中国医师协会骨科医师分会,中国医师协会骨科医师分会《早发性脊柱侧凸循证临床诊疗指南》编辑委员会.中国医师协会骨科医师分会骨科循证临床诊疗指南:早发性脊柱侧凸循证临床诊疗指南[J].中华外科杂志,2019,57(3):166-169.
[6] American spinal injury association(ASIA).Ninth annual scientific meeting April 11th-13th,1983,Denver,Colorado,U.S.A.Abstracts[J].Paraplegia,1984,22(1):45-54.
[7] AARABI B,AKHTAR D N,CHRYSSIKOS T,et al.Efficacy of ultra-early(<12 h),early(12-24 h),and late(>24-138.5 h)surgery with magnetic resonance imaging-confirmed decompression in american spinal injury association impairment scale grades A,B,and C cervical spinal cord injury[J].J Neurotrauma,2020,37(3):448-457.
[8] WANG T Y,PARK C,ZHANG H,et al.Management of acute traumatic spinal cord injury:a review of the literature[J].Front Surg,2021,8:698736.
[9] KAWAI M,NAGOSHI N,OKANO H,et al.A review of regenerative therapy for spinal cord injury using human iPS cells[J].N Am Spine Soc J,2022,13:100184.
[10] ISLAM F,BEPARY S,NAFADY M H,et al.Polyphenols targeting oxidative stress in spinal cord injury:current status and future vision[J].Oxid Med Cell Longev,2022:8741787.
[11] HUANG Y,XU W,ZHOU R.NLRP3 inflammasome activation and cell death[J].Cell Mol Immunol,2021,18(9):2114-2127.
[12] JIANG W,LI M,HE F,et al.Targeting the NLRP3 inflammasome to attenuate spinal cord injury in mice[J].J Neuroinflammation,2017,14(1):207.
[13] GUO R,GAO S,FENG Y,et al.Ulinastatin attenuates spinal cord injury by targeting AMPK/NLRP3 signaling pathway[J].J Chem Neuroanat,2022,125:102145.
[14] MI J,YANG Y,YAO H,et al.Inhibition of heat shock protein family A member 8 attenuates spinal cord ischemia-reperfusion injury via astrocyte NF-κB/NLRP3 inflammasome pathway:HSPA8 inhibition protects spinal ischemia-reperfusion injury[J].J Neuroinflammation,2021,18(1):170.
[15] LUO Y,ZHENG D,MOU T,et al.CMPK2 accelerates liver ischemia/reperfusion injury via the NLRP3 signaling pathway[J].Exp Ther Med,2021,22(6):1358.
[16] WANG J,ZHANG F,XU H,et al.TLR4 aggravates microglial pyroptosis by promoting DDX3X-mediated NLRP3 inflammasome activation via JAK2/STAT1 pathway after spinal cord injury[J].Clin Transl Med,2022,12(6):e894.
[17] RAHIMIAN R,BÉLAND L C,KRIZ J.Galectin-3:mediator of microglia responses in injured brain[J].Drug Discov Today,2018,23(2):375-381.
[18] TAN Y,ZHENG Y,XU D,et al.Galectin-3:a key player in microglia-mediated neuroinflammation and Alzheimer's disease[J].Cell Biosci,2021,11(1):78.
[19] BOROVCANIN M M,RADOSAVLJEVIC G D,PANTIC J,et al.Contrasting roles of the galectin-3 in the schizophrenia onset,clinical presentation,and somatic comorbidity[J].Curr Top Med Chem,2021,21(16):1471-1487.
[20] SAYED A,MUNIR M,NABET M S,et al.Galectin-3:a novel marker for the prediction of stroke incidence and clinical prognosis[J].Mediators Inflamm,2022:2924773.
[21] YANG C,XIA W,LIU X,et al.Role of TXNIP/NLRP3 in sepsis-induced myocardial dysfunction[J].Int J Mol Med,2019,44(2):417-426.
[22] REN Z,LIANG W,SHENG J,et al.Gal-3 is a potential biomarker for spinal cord injury and Gal-3 deficiency attenuates neuroinflammation through ROS/TXNIP/NLRP3 signaling pathway[J].Biosci Rep,2019,39(12):BSR20192368.

备注/Memo

备注/Memo:
基金项目:河北省医学科学研究课题项目(20190651)
更新日期/Last Update: 2024-05-15