Level and Significance of Related Factors of NLRP3/Caspase-1 Signaling Pathway in Peripheral Blood of Patients with Post-stroke Cognitive Impairment

YANG Guang; GUO Jin; LI Zibin; LIANG Jianjun

doi:10.3969/j.issn.1004-437X.2026.12.009

Abstract：Objective To investigate the changes of factors related to NLRP3/Caspase-1 signaling pathway in peripheral blood of stroke patients,and to analyze its predictive value for post-stroke cognitive impairment(PSCI).Methods A total of 120 stroke patients in Zhumadian Hospital of Traditional Chinese Medicine Affiliated to Henan University of Traditional Chinese Medicine from April 2022 to April 2024 were selected.According to whether cognitive impairment occurred 3 months after stroke,they were divided into 51 cases in the occurrence group and 69 cases in the non-occurrence group.The levels of NLRP3/Caspase-1 signaling pathway related factors[NLRP3,Caspase-1,interleukin-1β(IL-1 β),interleukin-18(IL-18)]in peripheral blood were compared between the two groups.The correlation between NLRP3,Caspase-1,IL-1 β,IL-18 and Montreal cognitive assessment(MoCA)score was analyzed.Multivariate logistic regression analysis was used to analyze the influencing factors of PSCI.The predictive efficacy of NLRP3,Caspase-1,IL-1 β and IL-18 on PSCI was analyzed.A total of 60 stroke patients admitted to hospital from May 2024 to May 2025 were selected as the time validation group to evaluate the combined predictive value of the above indicators.Results The serum levels of NLRP3,Caspase-1,IL-1 βand IL-18 in the occurrence group were higher than those in the non-occurrence group(P＜0.05).NLRP3,Caspase-1,IL-1 β and IL-18 were negatively correlated with MoCA score(P＜0.05).After adjusting the baseline National Institute of Health stroke scale(NIHSS)score,NLRP3,Caspase-1,IL-1β and IL-18 were still independently associated with PSCI(P＜0.05).The area under the curve(AUC)values of NLRP3,Caspase-1,IL-1β,IL-18 alone and combined prediction of PSCI were 0.742,0.753,0.769,0.738,0.882,respectively.The AUC value of combined prediction was significantly higher than that of single index prediction(P＜0.05),and the time verification showed that the combined prediction was highly consistent with the actual results.Conclusion The elevated levels of NLRP3,Caspase-1,IL-1 β and IL-18 in peripheral blood NLRP3/Caspase-1 signaling pathway-related factors are independently associated with PSCI.The detection of their levels has a certain predictive value for the occurrence of PSCI,and the combined detection has a higher predictive efficiency.