CAJ | 학술논문

目的通过前瞻性研究探讨早期脓毒症患者外周血单个核细胞中NLRP1炎性体和NLRP3炎性体相关组分的表达和血浆中相关炎症因子的水平,以及各指标的临床价值.方法脓毒症患者21例,年龄(67.71±17.17)岁；非感染性SIRS患者20例,年龄(61.35±11.82)岁；健康者20例,年龄(60.38 ±5.61)岁.Real-time PCR检测炎性体复合物各组分以及相关炎症因子mRNA表达水平,ELISA检测血浆IL-1β和IL-18质量浓度.统计方法使用单因素方差分析和Spearman相关性分析.结果 ①NLRP1在早期脓毒症患者和非感染性SIRS患者外周血单个核细胞(PBMC)中的mRNA表达均较健康对照组明显降低(P＜0.01),NLRP3在脓毒症患者PBMC中表达与健康对照组差异无统计学意义(P＞0.05),但其在非感染性SIRS组的表达较脓毒症组和健康对照组明显升高(P ＜0.01)；IL-1β在3组人群PBMC中的mRNA表达差异无统计学意义(P＞0.05),IL-18在脓毒症组和非感染性SIRS组中的表达均较健康对照组增高(P＜0.01),其中非感染性SIRS组IL-18表达水平最高.②脓毒症患者血浆中IL-1β的蛋白水平较健康对照组低(P＜0.05),IL-18水平较健康对照组和非感染性SIRS组显著升高(P＜0.01)；③NLRP1与SOFA评分呈负相关性(r=-0.44,P＜0.05)；与APACHEⅡ评分也具有负相关性(r=-0.52,P＜0.05).结论 NLRP1在早期脓毒症患者PBMC中表达明显降低,且其水平与患者病情严重程度呈负相关,NLRP1水平越低病情越严重.
목적 통과전첨성연구탐토조기농독증환자외주혈단개핵세포중NLRP1염성체화NLRP3염성체상관조분적표체화혈장중상관염증인자적수평,이급각지표적림상개치.방법 농독증환자21례,년령(67.71±17.17)세；비감염성SIRS환자20례,년령(61.35±11.82)세；건강자20례,년령(60.38 ±5.61)세.Real-time PCR검측염성체복합물각조분이급상관염증인자mRNA표체수평,ELISA검측혈장IL-1β화IL-18질량농도.통계방법사용단인소방차분석화Spearman상관성분석.결과 ①NLRP1재조기농독증환자화비감염성SIRS환자외주혈단개핵세포(PBMC)중적mRNA표체균교건강대조조명현강저(P＜0.01),NLRP3재농독증환자PBMC중표체여건강대조조차이무통계학의의(P＞0.05),단기재비감염성SIRS조적표체교농독증조화건강대조조명현승고(P ＜0.01)；IL-1β재3조인군PBMC중적mRNA표체차이무통계학의의(P＞0.05),IL-18재농독증조화비감염성SIRS조중적표체균교건강대조조증고(P＜0.01),기중비감염성SIRS조IL-18표체수평최고.②농독증환자혈장중IL-1β적단백수평교건강대조조저(P＜0.05),IL-18수평교건강대조조화비감염성SIRS조현저승고(P＜0.01)；③NLRP1여SOFA평분정부상관성(r=-0.44,P＜0.05)；여APACHEⅡ평분야구유부상관성(r=-0.52,P＜0.05).결론 NLRP1재조기농독증환자PBMC중표체명현강저,차기수평여환자병정엄중정도정부상관,NLRP1수평월저병정월엄중.
Objective To explore the mRNA expressions of NLRP1 (NOD-like receptor 1 ) and NLRP3 inflammasomescomponents and related pro-inflammation cytokines in peripheral blood mononuclear cells (PBMCs).Methods A total of 21 septic patients,20 non-infectious SIRS patients and 20 health subjects were enrolled in this study.The mRNA expressions of inflammasomes components and related proinflammation cytokines were measured by using RT-PCR,and serum levels of IL-1β and IL-18 were measured using ELISA.One-way ANOVA was usedd to compare the data of all three groups,and SNK-q was employed to compare thedata among different groups.Spearman correlation analysis was used to analyze the correlation between these biomarkers and the severity of septic patients.Results ①The mRNA expression of NLRP1 in PBMCs of septic patients in early stage and non-infectious SIRS patients was down-regulated in comparison with healthy subjects (P ＜0.01 ).The expression of NLRP3 in septic patients was not differentfrom that in healthy subjects ( P ＞ 0.05 ),but NLRP3 mRNA expression in non-infectious SIRS patients was significantly higher than that in septic patients and in healthy subjects ( P ＜ 0.01 ).ASC ( apoptosis associated speck like protein containing a CARD) and caspase-1 mRNA expressions in septic patients and non-infectious SIRS patients were higher than those in healthy subjects ( P ＜ 0.01 ).There was no difference in level of IL-1β found among all groups.IL-18 mRNA expression in septic patients and non-infectious SIRS patients was higher than that in healthy subjects ( P ＜ 0.01 ),and that in non-infectious SIRS patients was highest.②)Serum protein level of IL-1β in septic patients was lower than that in healthy subjects (P ＜0.05 ),and serum level of IL-18 in septic patients was significantly higher than that in non-infectious SIRS patients and in healthy subjects ( P ＜ 0.01 ).③NLRP1 was negatively related to SOFA ( sepsis-related organ failure assessment) score (r =-0.44,P ＜ 0.05 ) and negatively related to APACHE Ⅱ score as well ( r =- 0.52,P ＜ 0.05 ).Conclusions NLRP1 mRNA expression was down regulated in patients with early sepsis and its expression was negatively correlated to the severity of septic patients,indicating the lower NLRP1 mRNA expression the severer illness.