炎症小体NLRP3与手足口病重症化的相关性研究  

Association of NLRP3 level with severity of hand,foot and mouth disease

作　　者：王宸 邓慧玲[2,3] 张玉凤[2] 杜嘉仪 宋鹤 王军[2] 徐鹏飞[2] 袁娟[2] WANG Chen;DENG Hui-ling;ZHANG Yu-feng;DU Jia-yi;SONG He;WANG Jun;XU Peng-fei;YUAN Juan(Xi’an Medical College,Xi'an,Shaanxi 710021;Department of Infectious Diseases,Xi’an Children’s Hospital,Xi'an,Shaanxi 710003;Xi’an Central Hospital,Xi'an,Shaanxi 710003;University of North Carolina at Chapel Hill,North Carolina 27599,United States)

机构地区：[1]西安医学院研究生处,陕西西安710021 [2]西安市儿童医院感染二科,陕西西安710003 [3]西安市中心医院,陕西西安710003 [4]北卡罗来纳大学教堂山分校,北卡罗来纳州教堂山27599

出　　处：《热带医学杂志》2021年第4期423-426,共4页Journal of Tropical Medicine

基　　金：陕西省科技统筹重点产业创新链工程计划资助项目(2016KTZDSF02-04);西安市科技计划项目[201805098YX6SF32(7)]。

摘　　要：目的探讨核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)与手足口病(HFMD)重症化的相关性。方法选取2018年10月-2020年10月西安市儿童医院收治HFMD患儿共148例为病例组,根据病情严重程度分为普通组99例和重症组49例。选择同期性别及年龄相匹配健康儿童42名为对照组。采用ABC-ELISA检测病例组和对照组NLRP3、白介素-18(IL-18)和白介素-1β(IL-1β)的表达水平。结果HFMD病例组NLRP3、IL-18及IL-1β水平显著高于对照组,重症组血糖>8.3 mmol/L、白细胞计数(WBC)>15×109/L的比例及NLRP3、IL-1β和IL-18水平均高于普通组,差异均有统计学意义(P<0.05)。Spearman相关分析显示,NLRP3与IL-1β、IL-18存在正相关性(r=0.496、0.444,P均<0.05)。Logistic多因素回归分析显示,NLRP3水平、血糖>8.3 mmol/L和热程均为手足口病的危险因素(OR=1.303、4.687、1.987,P均<0.05)。受试者工作特征曲线分析显示,NLRP3最佳临界值为29.99 ng/mL,其对应灵敏性为81.6%,特异性为59.6%。结论NLRP3表达水平与HFMD严重程度相关,NLRP3>29.99 ng/mL对HFMD重症化有预警价值。Objective To evaluate the relationship between nucleotide-binding oligomerization domain-like receptors protein3(NLRP3)and the severity of hand-foot-and-mouth disease(HFMD).Methods Children with HFMD admitted to Xi.an Children.s Hospital from October 2018 to October 2020 were divided into general case group(n=99)and severe case group(n=49).Forty-two healthy children whose gender and age matched with those of children in the case group in the same period were selected as the control group.ABC-ELISA was used to detect the expression of NLRP3,interleukin-18(IL-18)and interleukin-1β(IL-1β)in the two groups of patients with different severity of HFMD.Results The levels of NLRP3,IL-18 and IL-1βin the case group of HFMD were significantly higher than those in the control group(P<0.01).The levels of NLRP3,IL-18 and IL-1βin the severe HFMD group were significantly higher than those in the normal group(P<0.01).Spearman correlation analysis showed that there was a positive correlation between NLRP3 and IL-1β,NLRP3 and IL-18(r=0.496 and 0.444,P<0.01,respectively).Multivariate logistic regression analysis showed that NLRP3 level,blood glucose>8.3 mmol/L and heat course were all risk factors for HFMD(OR=1.303,4.687,1.987,P<0.01 respectively).The analysis of the receiver operating characteristic curve showed that the best critical value of NLRP3 was 29.99 ng/mL.The corresponding sensitivity and specificity were 81.6%and 59.6%.Conclusions The level of NLRP3 was positively correlated with the severity of HFMD.NLRP3 level could provide early warning for the severity of HFMD.

关 键 词：手足口病 NLRP3 重症 

分 类 号：R512.5[医药卫生—内科学]