Value of NLRP3 Inflammatome and Its Downstream Factors in Predicting Poor Short-Term Prognosis in Patients with Subarachnoid Hemorrhage After Interventional Surgery
ZHAO Xiaobo
LI Fenbao
CUI Hongkai
Abstract：Objective To investigate the value of NOD-like receptor protein 3(NLRP3)inflammasome and its downstream factors in predicting the short term prognosis of patients with subarachnoid hemorrhage(SAH)after interventional surgery.Methods A total of 150 SAH patients admitted to the First Affiliated Hospital of Xinxiang Medical College from January 2021 to December 2023 were selected as the study objects,all of whom underwent vascular interventioembolization,and were divided into good prognosis group and poor prognosis group according to Glasgow prognosis score(GOS)three months after surgery.The general data,NLRP3 inflammasome and its downstream factors[casepase-1,interleukin(IL)-1β,IL-18]of the two groups were compared,and the adverse prognostic factors were screened by LASSO-logistic regression equation.Receiver operating characteristic(ROC)curve,decision curve analysis(DCA)and clinical impact curve(CIC)were used to analyze the single and combined predictive value of each indicator.Results(1)The incidence of delayed cerebral ischemia and shunt dependent hydrocephalus,the proportions of Hunt-Hess grade Ⅳ-Ⅴ and Fisher grade 3-4,the level of protein expressions of NLRP3,casepase-1,IL-1β and IL-18 in the poor prognosis group were higher than good prognosis group,the difference was statistically significant(P＜0.05).(2)High expression of NLRP3,casepase-1,IL-1β,IL-18 and shingway-dependent hydrocephalus were high risk factors for poor short-term prognosis in SAH patients after intervention(P＜0.05).(3)NLRP3+casepase-1+IL-1β+IL-18 was superior to NLRP3,casepase-1,IL-1β and IL-18 in predicting short term poor prognosis after intervention in SAH patients(AUC:0.913 vs 0.839,0.802,0.761).(4)In the threshold range of 0.2-1.0,the net benefit of NLRP3+casepase-1+IL-1β+IL-18 composite prediction model was greater than that of NLRP3,casepase-1,IL-1β and IL-18 single prediction model.When the threshold probability was 0.6-1.0,the number of poor prognoses predicted by NLRP3+casepase-1+IL-1β+IL-18 matching model was basically the same as the number of true positive.Conclusion The high expression of NLRP3,casepase-1,IL-1β and IL-18 protein is a high risk factor for poor short-term prognosis in patients with SAH after interventional surgery.Combined detection can improve the prediction efficiency,guide follow-up examination and treatment,and promote the improvement of prognosis.
Keywords：subarachnoid hemorrhagevascular interventional embolizationprognosisNOD-like receptor protein 3
Publication Date：2025-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 833-837 )