MRSA感染重症肺炎患者NLRP3、Caspase-1、TLR4 mRNA水平与病情程度及预后的关联  

Association of NLRP3,Caspase-1 and TLR4 mRNA with severity and prognosis ofpatients with severe MRSA pneumonia

作　　者：王莉莉[1] 李东玲 张婧岑 黄文龙 孙诗尧[1] WANG Lili;LI Dongling;ZHANG Jingcen;HUANG Wenlong;SUN Shiyao(Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning 110004,China)

机构地区：[1]中国医科大学附属盛京医院第一重症监护室病房,辽宁沈阳110004

出　　处：《中华医院感染学杂志》2025年第3期336-340,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省卫生健康委员会基金资助项目(2022LK031501)。

摘　　要：目的研究耐甲氧西林金黄色葡萄球菌(MRSA)感染重症肺炎患者核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、半胱氨酸蛋白酶1(Caspase-1)、Toll样受体4(TLR4)信使核糖核酸(mRNA)水平,并分析各指标与病情程度及预后的关系。方法选取中国医科大学附属盛京医院2020年6月—2023年6月收治的103例MRSA感染肺炎患者设为MRSA感染组,同期收治的112例常规感染肺炎患者设为非MRSA感染组。统计两组外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA水平,比较不同病情程度MRSA感染肺炎患者及不同预后MRSA感染重症肺炎患者外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA水平。采用受试者工作特征(ROC)曲线分析外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA对MRSA感染重症肺炎患者预后的预测价值。结果MRSA感染组外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA分别为(1.53±0.29)、(2.04±0.49)、(1.04±0.32)高于非MRSA感染组(P<0.05)。重症MRSA感染组外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA水平高于非重症MRSA感染组(P<0.05)。预后不良组外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA分别为(2.47±0.72)、(2.84±0.90)、(1.94±0.63)高于预后良好组(P<0.05)。外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA联合预测MRSA感染重症肺炎患者预后的曲线下面积(AUC)为0.853,高于三者单独检测(P<0.05)。结论随着MRSA感染肺炎患者病情的发生和进展,外周血NLRP3 mRNA、Caspase-1 mRNA、TLR4 mRNA水平升高,且三者联合对MRSA感染重症肺炎患者预后的预测价值较高。OBJECTIVE To study the relationship of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),cysteine protease 1(Caspase-1)and Toll-like receptor 4(TLR4)messenger ribonucleic acid(mRNA)with the severity and prognosis of patients with severe methicillin-resistant Staphylococcus aureus(MRSA)pneumonia.METHODS One hundred and three patients with MRSA-infected pneumonia admitted to Shengjing Hospital affiliated to China Medical University from Jun.2020 to Jun.2023 were selected as the MRSA-infected group,and 112 patients with conventional-infected pneumonia admitted during the same period were selected as the non-MR-SA-infected group.The levels of NLRP3 mRNA,Caspase-1 mRNA and TLR4 mRNA in peripheral blood of the two groups were tested,and their levels in peripheral blood of patients with pneumonia infected by MRSA with different severity and different prognosis were compared.The predictive values of NLRP3 mRNA,Caspase-l mRNA and TLR4 mRNA were analyzed by receiver operating characteristic(ROC)curve.RESULTS The peripheral blood NLRP3 mRNA,Caspase-1 mRNA,and TLR4 mRNA levels in the MRSA-infected group were(1.53±0.29),(2.04±0.49)and(1.04±0.32),higher than those in the non-MRSA-infected group(P<0.05),respectively.The mRNA levels of NLRP3,Caspase-1,and TLR4 in peripheral blood of the severe MRSA-infected group were higher than those of the non-severe MRSA-infected group(P<0.05).The peripheral blood NLRP3 mRNA,Caspase-1 mRNA,and TLR4 mRNA levels in the poor prognosis group were(2.47±0.72),(2.84±0.90)and(1.94±0.63),higher than those in the good prognosis group(P<0.05),respectively.The area under the curve(AUC)of the combination of peripheral blood NLRP3 mRNA,Caspase-1 mRNA and TLR4 mRNA to predict the prognosis of MRSA-infected patients with severe pneumonia was O.853,which was higher than that of the three indexes alone(P<0.05).CONCLUSION Peripheral blood NLRP3 mRNA,Caspase-1 mRNA and TLR4 mRNA levels are elevated with the onset and progress of disease in patients with MRSA-infected pneumonia,and t

关 键 词：重症肺炎 耐甲氧西林金黄色葡萄球菌 核苷酸结合寡聚化结构域样受体蛋白3 半胱氨酸蛋白酶1 Toll样受体4 信使核糖核酸 病情程度 预后 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]