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。
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
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 multi-variate 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 prog-nosis 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 progno-sis 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:Scrum Gal-3 and NLRP3 levels in TSCI patients are significantly increased,which is associated with the sever-ity of spinal cord injury and poor prognosis after surgery.Gal-3 and NLRP3 can be used as prognostic markers of TSCI.
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